MS-N140 · Cancer control · Biomarker-only human evidence · Safety · Human evidence · Appraised 26 October 2026

Does soursop (graviola, guanabana; Annona muricata) leaf extract control colorectal cancer in people?

Evidence at a glance

• Evidence label: Insufficient human evidence; a tiny trial measured laboratory cytotoxicity, not tumor response or survival
• Benefit: No verified improvement in recurrence, progression or survival has been shown.
• Certainty: Low. The accessible human study was small, short and used ex-vivo cell-line outcomes that cannot establish cancer control.
• Risk: Concentrated Annonaceae products raise neurotoxicity concerns; product identity, dose and interactions are uncertain.

What was studied

Traditional context and formulation: Annona muricata foods and plant preparations have documented traditional uses in tropical regions. Documented use is not evidence of anticancer benefit. The clinical study tested a specific ethanolic leaf extract, 300 mg daily for 8 weeks, rather than ordinary fruit intake.

Population and design: Twenty-eight adults after primary colorectal-tumor resection completed a randomized placebo-controlled study (14 per group). Most in the extract group also received chemotherapy. Outcomes included nutritional measures and how participants’ serum affected colorectal and kidney cell lines outside the body.

What the evidence found

Serum from the extract group reduced viability in one colorectal cell line (DLD-1) but not another (COLO205); nutritional measures did not clearly improve. The study did not report radiographic tumor response, recurrence, progression-free survival or overall survival.

A systematic safety review found very limited human data. Observational and experimental literature links Annonaceae exposure and the acetogenin annonacin with concern about atypical parkinsonism and neuronal toxicity, but the exact risk from any one food or supplement dose is not established.

How to interpret it

A blood sample affecting cultured cells is a laboratory endpoint, even when the blood came from trial participants. It cannot show that a tumor in a person shrank or that treatment improved survival.

Fruit as food and concentrated leaf, bark, root, seed or capsule preparations are not interchangeable. The clinical formulation should not be generalized to homemade teas or commercial supplements.

Practical safety context

Avoid using concentrated soursop products in place of surgery, systemic therapy or surveillance. People with neurologic symptoms, low blood pressure, diabetes treatment, pregnancy, liver or kidney disease should be especially cautious because safety and interaction data are incomplete. Report new tremor, stiffness, slowed movement, confusion or neuropathic symptoms promptly.

Questions for the care team

• Is this ordinary food use or a concentrated leaf, bark, root or seed product?
• Does the cited study measure a patient-important outcome, or only a laboratory marker?
• Could this product interact with blood-pressure, glucose-lowering or cancer medicines?

Funding and conflicts

Funding and conflicts for the 28-person trial were not verified in the accessible abstract and article copy. The small sample, surrogate outcome and concurrent chemotherapy sharply limit attribution.

Sources

• Randomized colorectal-cancer study (PMID 28582808)
• Full-text trial report
• Systematic safety review (PMID 31659754)
• Annona muricata supplement risk assessment (PMID 33294051)
• Annonaceae exposure and parkinsonism severity study (PMID 36210778)

Last literature search: 26 October 2026. Record appraisal: 26 October 2026. This page is educational and does not replace individualized medical advice. Laboratory effects, biomarkers, symptom changes or an uncontrolled response must not be interpreted as proof of tumor control, delayed recurrence or longer survival.