INTEGRATING AYURVEDIC PRINCIPLES INTO MODERN PALLIATIVE CANCER CARE: A NARRATIVE REVIEW
Main Article Content
Keywords
Ayurveda; Palliative Care; Cancer; Integrative Oncology; Quality of Life; Complementary Medicine; Symptom Management
Abstract
Background: The global burden of advanced cancer is characterized by significant symptom distress and unmet supportive care needs. Modern palliative care, while essential, may be supplemented by holistic traditional systems. Ayurveda, a personalized, whole-system traditional medicine from India, aligns conceptually with palliative care goals.
Objective: This narrative review explores the theoretical foundations of Ayurveda, its potential integration into palliative cancer care for symptom management and psychosocial support, and evaluates the existing evidence base.
Methods: A narrative synthesis of peer-reviewed literature from PubMed, Scopus, and AYUSH research portals was conducted, focusing on Ayurvedic principles, clinical studies in oncology/palliative care, and integrative medicine frameworks.
Results: Ayurveda’s core principles—individual constitution (Prakriti), bio-energetic balance (Doshas), and holistic health—resonate with the biopsychosocial-spiritual model of palliative care. Preliminary evidence suggests potential benefits of specific interventions: Rasayana (rejuvenation) herbs (e.g., Withania somnifera) for cancer-related fatigue; mind-body practices (yoga, meditation) for anxiety and depression; herbal and dietary strategies for gastrointestinal symptoms; and adjuvant herbal analgesics (e.g., Boswellia serrata) for pain. Major challenges include a limited high-quality clinical evidence base, safety concerns regarding herb-drug interactions, and a lack of standardized integrative care models.
Conclusions: Ayurveda offers a patient-centered, holistic framework that may complement conventional palliative oncology care. While current evidence is encouraging but preliminary, rigorous clinical research, interdisciplinary collaboration, and standardized safety protocols are needed to responsibly integrate these approaches. Thoughtful synthesis of Ayurvedic principles with modern palliative care holds promise for enhancing the quality of life and addressing the multidimensional suffering of patients with advanced cancer.
References
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15. Patwardhan B. The history of the discovery of blood circulation: unrecognized contributions of Ayurveda masters. Adv Physiol Educ. 2012;36(2):77-82.
16. Mishra LC, Singh BB, Dagenais S. Ayurveda: a historical perspective and principles of the traditional healthcare system in India. Altern Ther Health Med. 2001;7(2):36-42.
17. Chandola HM. Role of Agni in the Pathogenesis of Diabetes. Anc Sci Life. 1985;4(3):164-168.
18. Patil VC, Baghel MS, Thakar AB. A review of the concept of Samprapti (Pathogenesis) in Ayurveda. AYU. 2011;32(3):314-319.
19. Telles S, Naveen KV, Balkrishna A. Use of Ayurveda in promoting dental health and preventing dental caries. Indian J Dent Res. 2009;20(4):466.
20. Narayana A, Subhose V. Standardization of Ayurvedic polyherbal formulations: A review of current methodologies. J Ayurveda Integr Med. 2015;6(1):13-19.
21. Rastogi S. Building bridges between Ayurveda and modern science. Int J Ayurveda Res. 2010;1(1):41-46.
22. Kessler CS, Michalsen A. The role of whole medical systems in global medicine. Complement Med Res. 2012;19(2):65-66.
23. Thakar VJ. Diagnosis and management of pain in Ayurveda. Anc Sci Life. 1986;5(3):169-175.
24. Kumar S, Prasad A, Iyengar S. Effect of Abhyanga (oil massage) on physiological and psychological parameters in healthy volunteers. J Ayurveda Integr Med. 2021;12(3):529-533.
25. Pratte MA, Nanavati KB, Young V, Morley CP. An alternative treatment for anxiety: a systematic review of human trial results reported for the Ayurvedic herb ashwagandha (Withania somnifera). J Altern Complement Med. 2014;20(12):901-908.
26. Siddiqui MZ. Boswellia serrata, a potential antiinflammatory agent: an overview. Indian J Pharm Sci. 2011;73(3):255-261.
27. Singh BB, Mishra LC, Vinjamury SP. The role of guggulu in inflammatory disorders. Altern Ther Health Med. 2003;9(2):74-80.
28. Gupta SC, Patchva S, Aggarwal BB. Therapeutic roles of curcumin: lessons learned from clinical trials. AAPS J. 2013;15(1):195-218.
29. Balachandran P, Govindarajan R. Cancer--an Ayurvedic perspective. Pharmacol Res. 2005;51(1):19-30.
30. Biswal BM, Sulaiman SA, Ismail HC, Zakaria H, Musa KI. Effect of Withania somnifera (Ashwagandha) on the development of chemotherapy-induced fatigue and quality of life in breast cancer patients. Integr Cancer Ther. 2013;12(4):312-322.
31. Sharma U, Bala M, Kumar N, et al. Anti-fatigue activity of Tinospora cordifolia in experimentally induced fatigue. Pharmacognosy Res. 2012;4(4):223-226.
32. Cramer H, Lauche R, Klose P, et al. Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer. Cochrane Database Syst Rev. 2017;1(1):CD010802.
33. Lad V. Ayurveda: The Science of Self-Healing. Lotus Press; 1984.
34. Marx W, Ried K, McCarthy AL, et al. Ginger-Mechanism of action in chemotherapy-induced nausea and vomiting: A review. Crit Rev Food Sci Nutr. 2017;57(1):141-146.
35. Peterson CT, Denniston K, Chopra D. Therapeutic Uses of Triphala in Ayurvedic Medicine. J Altern Complement Med. 2017;23(8):607-614.
36. Dwivedi V, Anandan EM, Mony RS, et al. In vitro effect of Brahmi ghrita, an Ayurvedic formulation, on lipopolysaccharide-induced changes in cyclooxygenase-2 and inducible nitric oxide synthase expression in rat glioma cells. J Ayurveda Integr Med. 2012;3(2):73-77.
37. Mooventhan A, Nivethitha L. Evidence based effects of yoga in neurological disorders. J Clin Neurosci. 2017;43:61-67.
38. Cillessen L, Johannsen M, Speckens AEM, Zachariae R. Mindfulness-based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta-analysis of randomized controlled trials. Psychooncology. 2019;28(12):2257-2269.
39. Chandrasekhar K, Kapoor J, Anishetty S. A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults. Indian J Psychol Med. 2012;34(3):255-262.
40. Agarwal A, Diwanay S, Patki P, Patwardhan B. Studies on immunomodulatory activity of Withania somnifera (Ashwagandha) extracts in experimental immune inflammation. J Ethnopharmacol. 1999;67(1):27-35.
41. Dhruva A, Miaskowski C, Abrams D, et al. Ayurveda for breast cancer survivors: a pilot randomized controlled trial. Integr Cancer Ther. 2015;14(3):242-250.
42. Buffart LM, van Uffelen JG, Riphagen II, et al. Physical and psychosocial benefits of yoga in cancer patients and survivors, a systematic review and meta-analysis of randomized controlled trials. BMC Cancer. 2012;12:559.
43. Stough C, Downey LA, Lloyd J, et al. Examining the nootropic effects of a special extract of Bacopa monniera on human cognitive functioning: 90 day double-blind placebo-controlled randomized trial. Phytother Res. 2008;22(12):1629-1634.
44. Kimmatkar N, Thawani V, Hingorani L, Khiyani R. Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee--a randomized double blind placebo controlled trial. Phytomedicine. 2003;10(1):3-7.
45. Kulkarni SK, Dhir A. Withania somnifera: an Indian ginseng. Prog Neuropsychopharmacol Biol Psychiatry. 2008;32(5):1093-1105.
46. Warrier M. Seekership, Spirituality and Self-Discovery: Ayurveda Trainees in Britain. Asian Med (Leiden). 2009;4(2):423-451.
47. Rastogi S, Chiappelli F, Ramchandani MH, Singh RH. The scope of Ayurveda in integrative oncology. In: Evidence-Based Practice in Complementary and Alternative Medicine. Springer; 2012:165-179.
48. Narayana A, Subhose V. Standardization of Ayurvedic polyherbal formulations: A review of current methodologies. J Ayurveda Integr Med. 2015;6(1):13-19.
49. Patwardhan B, Warude D, Pushpangadan P, Bhatt N. Ayurveda and traditional Chinese medicine: a comparative overview. Evid Based Complement Alternat Med. 2005;2(4):465-473.
50. Posadzki P, Watson LK, Ernst E. Adverse effects of herbal medicines: an overview of systematic reviews. Clin Med (Lond). 2013;13(1):7-12.
51. Scott GN, Elmer GW. Update on natural product--drug interactions. Am J Health Syst Pharm. 2002;59(4):339-347.
52. Saper RB, Phillips RS, Sehgal A, et al. Lead, mercury, and arsenic in US- and Indian-manufactured Ayurvedic medicines sold via the Internet. JAMA. 2008;300(8):915-923.
53. Canaway R, Manderson L. Quality of life, perceptions of health and illness, and complementary therapy use among people with type 2 diabetes and cardiovascular disease. J Altern Complement Med. 2013;19(11):882-890.
54. Dwyer J, Orr R. The ethics of traditional and complementary medicine. In: The Oxford Textbook of Clinical Research Ethics. Oxford University Press; 2008.
55. Frenkel M, Ben-Arye E, Cohen L. Communication in cancer care: discussing complementary and alternative medicine. Integr Cancer Ther. 2010;9(2):177-185.
56. Gogtay NJ, Bhatt HA, Dalvi SS, Kshirsagar NA. The use and safety of non-allopathic Indian medicines. Drug Saf. 2002;25(14):1005-1019.
57. Fønnebø V, Grimsgaard S, Walach H, et al. Researching complementary and alternative treatments--the gatekeepers are not at home. BMC Med Res Methodol. 2007;7:7.
58. Basch E, Abernethy AP, Mullins CD, et al. Recommendations for incorporating patient-reported outcomes into clinical comparative effectiveness research in adult oncology. J Clin Oncol. 2012;30(34):4249-4255.
59. Singh N, Bhalla M, de Jager P, Gilca M. An overview on ashwagandha: a Rasayana (rejuvenator) of Ayurveda. Afr J Tradit Complement Altern Med. 2011;8(5 Suppl):208-213.
60. Prasher B, Negi S, Aggarwal S, et al. Whole genome expression and biochemical correlates of extreme constitutional types defined in Ayurveda. J Transl Med. 2008;6:48.
61. Verhoef MJ, Vanderheyden LC, Dryden T, Mallory D, Ware MA. Evaluating complementary and alternative medicine interventions: in search of appropriate patient-centered outcome measures. BMC Complement Altern Med. 2006;6:38.
62. Bauer MS, Damschroder L, Hagedorn H, Smith J, Kilbourne AM. An introduction to implementation science for the non-specialist. BMC Psychol. 2015;3:32.
63. Ben-Arye E, Frenkel M, Klein A, Scharf M. Attitudes toward integration of complementary and alternative medicine in primary care: perspectives of patients, physicians and complementary practitioners. Patient Educ Couns. 2008;70(3):395-402.
2. Hui D, Bruera E. Integrating Palliative Care Into the Trajectory of Cancer Care. Nat Rev Clin Oncol. 2016;13(3):159-171.
3. Teunissen SC, Wesker W, Kruitwagen C, de Haes HC, Voest EE, de Graeff A. Symptom prevalence in patients with incurable cancer: a systematic review. J Pain Symptom Manage. 2007;34(1):94-104.
4. World Health Organization. Palliative Care. [Fact sheet]. 2020. Accessed [Date]. https://www.who.int/news-room/fact-sheets/detail/palliative-care
5. Kogan M, Cheng S, Rao S, DeMocker S, Korones DN. Integrating Palliative Care into Primary Care. Prim Care. 2019;46(3):447-464.
6. Temel JS, Greer JA, Muzikansky A, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med. 2010;363(8):733-742.
7. Haun MW, Estel S, Rücker G, et al. Early palliative care for adults with advanced cancer. Cochrane Database Syst Rev. 2017;6(6):CD011129.
8. Keene MR, Heslop IM, Sabesan SS, Glass BD. Complementary and alternative medicine use in cancer: A systematic review. Complement Ther Clin Pract. 2019;35:33-47.
9. Yates JS, Mustian KM, Morrow GR, et al. Prevalence of complementary and alternative medicine use in cancer patients during treatment. Support Care Cancer. 2005;13(10):806-811.
10. Sharma H, Chandola HM, Singh G, Basisht G. Utilization of Ayurveda in health care: an approach for prevention, health promotion, and treatment of disease. Part 1--Ayurveda, the science of life. J Altern Complement Med. 2007;13(9):1011-1019.
11. Rotti H, Guruprasad KP, Nayak J, et al. Immunophenotyping of normal individuals classified on the basis of human dosha prakriti. J Ayurveda Integr Med. 2014;5(1):43-49.
12. Dhruva A, Hecht FM, Miaskowski C, et al. Correlating traditional Ayurvedic and modern medical perspectives on cancer: results of a qualitative study. J Altern Complement Med. 2014;20(5):364-370.
13. Hankey A. The scientific value of Ayurveda. J Altern Complement Med. 2005;11(2):221-225.
14. Rotti H, Guruprasad KP, Nayak J, et al. Immunophenotyping of normal individuals classified on the basis of human dosha prakriti. J Ayurveda Integr Med. 2014;5(1):43-49.
15. Patwardhan B. The history of the discovery of blood circulation: unrecognized contributions of Ayurveda masters. Adv Physiol Educ. 2012;36(2):77-82.
16. Mishra LC, Singh BB, Dagenais S. Ayurveda: a historical perspective and principles of the traditional healthcare system in India. Altern Ther Health Med. 2001;7(2):36-42.
17. Chandola HM. Role of Agni in the Pathogenesis of Diabetes. Anc Sci Life. 1985;4(3):164-168.
18. Patil VC, Baghel MS, Thakar AB. A review of the concept of Samprapti (Pathogenesis) in Ayurveda. AYU. 2011;32(3):314-319.
19. Telles S, Naveen KV, Balkrishna A. Use of Ayurveda in promoting dental health and preventing dental caries. Indian J Dent Res. 2009;20(4):466.
20. Narayana A, Subhose V. Standardization of Ayurvedic polyherbal formulations: A review of current methodologies. J Ayurveda Integr Med. 2015;6(1):13-19.
21. Rastogi S. Building bridges between Ayurveda and modern science. Int J Ayurveda Res. 2010;1(1):41-46.
22. Kessler CS, Michalsen A. The role of whole medical systems in global medicine. Complement Med Res. 2012;19(2):65-66.
23. Thakar VJ. Diagnosis and management of pain in Ayurveda. Anc Sci Life. 1986;5(3):169-175.
24. Kumar S, Prasad A, Iyengar S. Effect of Abhyanga (oil massage) on physiological and psychological parameters in healthy volunteers. J Ayurveda Integr Med. 2021;12(3):529-533.
25. Pratte MA, Nanavati KB, Young V, Morley CP. An alternative treatment for anxiety: a systematic review of human trial results reported for the Ayurvedic herb ashwagandha (Withania somnifera). J Altern Complement Med. 2014;20(12):901-908.
26. Siddiqui MZ. Boswellia serrata, a potential antiinflammatory agent: an overview. Indian J Pharm Sci. 2011;73(3):255-261.
27. Singh BB, Mishra LC, Vinjamury SP. The role of guggulu in inflammatory disorders. Altern Ther Health Med. 2003;9(2):74-80.
28. Gupta SC, Patchva S, Aggarwal BB. Therapeutic roles of curcumin: lessons learned from clinical trials. AAPS J. 2013;15(1):195-218.
29. Balachandran P, Govindarajan R. Cancer--an Ayurvedic perspective. Pharmacol Res. 2005;51(1):19-30.
30. Biswal BM, Sulaiman SA, Ismail HC, Zakaria H, Musa KI. Effect of Withania somnifera (Ashwagandha) on the development of chemotherapy-induced fatigue and quality of life in breast cancer patients. Integr Cancer Ther. 2013;12(4):312-322.
31. Sharma U, Bala M, Kumar N, et al. Anti-fatigue activity of Tinospora cordifolia in experimentally induced fatigue. Pharmacognosy Res. 2012;4(4):223-226.
32. Cramer H, Lauche R, Klose P, et al. Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer. Cochrane Database Syst Rev. 2017;1(1):CD010802.
33. Lad V. Ayurveda: The Science of Self-Healing. Lotus Press; 1984.
34. Marx W, Ried K, McCarthy AL, et al. Ginger-Mechanism of action in chemotherapy-induced nausea and vomiting: A review. Crit Rev Food Sci Nutr. 2017;57(1):141-146.
35. Peterson CT, Denniston K, Chopra D. Therapeutic Uses of Triphala in Ayurvedic Medicine. J Altern Complement Med. 2017;23(8):607-614.
36. Dwivedi V, Anandan EM, Mony RS, et al. In vitro effect of Brahmi ghrita, an Ayurvedic formulation, on lipopolysaccharide-induced changes in cyclooxygenase-2 and inducible nitric oxide synthase expression in rat glioma cells. J Ayurveda Integr Med. 2012;3(2):73-77.
37. Mooventhan A, Nivethitha L. Evidence based effects of yoga in neurological disorders. J Clin Neurosci. 2017;43:61-67.
38. Cillessen L, Johannsen M, Speckens AEM, Zachariae R. Mindfulness-based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta-analysis of randomized controlled trials. Psychooncology. 2019;28(12):2257-2269.
39. Chandrasekhar K, Kapoor J, Anishetty S. A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults. Indian J Psychol Med. 2012;34(3):255-262.
40. Agarwal A, Diwanay S, Patki P, Patwardhan B. Studies on immunomodulatory activity of Withania somnifera (Ashwagandha) extracts in experimental immune inflammation. J Ethnopharmacol. 1999;67(1):27-35.
41. Dhruva A, Miaskowski C, Abrams D, et al. Ayurveda for breast cancer survivors: a pilot randomized controlled trial. Integr Cancer Ther. 2015;14(3):242-250.
42. Buffart LM, van Uffelen JG, Riphagen II, et al. Physical and psychosocial benefits of yoga in cancer patients and survivors, a systematic review and meta-analysis of randomized controlled trials. BMC Cancer. 2012;12:559.
43. Stough C, Downey LA, Lloyd J, et al. Examining the nootropic effects of a special extract of Bacopa monniera on human cognitive functioning: 90 day double-blind placebo-controlled randomized trial. Phytother Res. 2008;22(12):1629-1634.
44. Kimmatkar N, Thawani V, Hingorani L, Khiyani R. Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee--a randomized double blind placebo controlled trial. Phytomedicine. 2003;10(1):3-7.
45. Kulkarni SK, Dhir A. Withania somnifera: an Indian ginseng. Prog Neuropsychopharmacol Biol Psychiatry. 2008;32(5):1093-1105.
46. Warrier M. Seekership, Spirituality and Self-Discovery: Ayurveda Trainees in Britain. Asian Med (Leiden). 2009;4(2):423-451.
47. Rastogi S, Chiappelli F, Ramchandani MH, Singh RH. The scope of Ayurveda in integrative oncology. In: Evidence-Based Practice in Complementary and Alternative Medicine. Springer; 2012:165-179.
48. Narayana A, Subhose V. Standardization of Ayurvedic polyherbal formulations: A review of current methodologies. J Ayurveda Integr Med. 2015;6(1):13-19.
49. Patwardhan B, Warude D, Pushpangadan P, Bhatt N. Ayurveda and traditional Chinese medicine: a comparative overview. Evid Based Complement Alternat Med. 2005;2(4):465-473.
50. Posadzki P, Watson LK, Ernst E. Adverse effects of herbal medicines: an overview of systematic reviews. Clin Med (Lond). 2013;13(1):7-12.
51. Scott GN, Elmer GW. Update on natural product--drug interactions. Am J Health Syst Pharm. 2002;59(4):339-347.
52. Saper RB, Phillips RS, Sehgal A, et al. Lead, mercury, and arsenic in US- and Indian-manufactured Ayurvedic medicines sold via the Internet. JAMA. 2008;300(8):915-923.
53. Canaway R, Manderson L. Quality of life, perceptions of health and illness, and complementary therapy use among people with type 2 diabetes and cardiovascular disease. J Altern Complement Med. 2013;19(11):882-890.
54. Dwyer J, Orr R. The ethics of traditional and complementary medicine. In: The Oxford Textbook of Clinical Research Ethics. Oxford University Press; 2008.
55. Frenkel M, Ben-Arye E, Cohen L. Communication in cancer care: discussing complementary and alternative medicine. Integr Cancer Ther. 2010;9(2):177-185.
56. Gogtay NJ, Bhatt HA, Dalvi SS, Kshirsagar NA. The use and safety of non-allopathic Indian medicines. Drug Saf. 2002;25(14):1005-1019.
57. Fønnebø V, Grimsgaard S, Walach H, et al. Researching complementary and alternative treatments--the gatekeepers are not at home. BMC Med Res Methodol. 2007;7:7.
58. Basch E, Abernethy AP, Mullins CD, et al. Recommendations for incorporating patient-reported outcomes into clinical comparative effectiveness research in adult oncology. J Clin Oncol. 2012;30(34):4249-4255.
59. Singh N, Bhalla M, de Jager P, Gilca M. An overview on ashwagandha: a Rasayana (rejuvenator) of Ayurveda. Afr J Tradit Complement Altern Med. 2011;8(5 Suppl):208-213.
60. Prasher B, Negi S, Aggarwal S, et al. Whole genome expression and biochemical correlates of extreme constitutional types defined in Ayurveda. J Transl Med. 2008;6:48.
61. Verhoef MJ, Vanderheyden LC, Dryden T, Mallory D, Ware MA. Evaluating complementary and alternative medicine interventions: in search of appropriate patient-centered outcome measures. BMC Complement Altern Med. 2006;6:38.
62. Bauer MS, Damschroder L, Hagedorn H, Smith J, Kilbourne AM. An introduction to implementation science for the non-specialist. BMC Psychol. 2015;3:32.
63. Ben-Arye E, Frenkel M, Klein A, Scharf M. Attitudes toward integration of complementary and alternative medicine in primary care: perspectives of patients, physicians and complementary practitioners. Patient Educ Couns. 2008;70(3):395-402.
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Dec 31, 2025
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Dr Rashmi Gupta. (2025). INTEGRATING AYURVEDIC PRINCIPLES INTO MODERN PALLIATIVE CANCER CARE: A NARRATIVE REVIEW. Journal of Population Therapeutics and Clinical Pharmacology, 26(2), 121-135. https://doi.org/10.53555/6dgx4f02
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Author Biography
Dr Rashmi Gupta
Associate professor, Department of Shalya Tantra, Faculty of Ayurveda, Institute of Medical sciences, Banaras Hindu University, Varanasi, 221005
How to Cite
Dr Rashmi Gupta. (2025). INTEGRATING AYURVEDIC PRINCIPLES INTO MODERN PALLIATIVE CANCER CARE: A NARRATIVE REVIEW. Journal of Population Therapeutics and Clinical Pharmacology, 26(2), 121-135. https://doi.org/10.53555/6dgx4f02
