From the Guidelines
Melatonin is not recommended for the treatment of cancer-related fatigue.
Current Status of Melatonin in Cancer Treatment
- The current evidence suggests that melatonin is not effective in managing cancer-related fatigue, with studies showing no significant differences in fatigue levels compared to placebo 1.
- The American Society of Clinical Oncology (ASCO) and the European Society for Medical Oncology (ESMO) have not recommended melatonin for the control of cancer-related fatigue due to insufficient evidence 1.
- In fact, the ESMO clinical practice guidelines explicitly state that the use of melatonin is not recommended for the control of cancer-related fatigue [II, D] 1.
- Other treatments, such as corticosteroids, cognitive behavioral therapy, and exercise, may be recommended for managing cancer-related fatigue, depending on the individual patient's circumstances and preferences 1.
- A study using 20 mg of melatonin once daily for 1 week found no significant differences in fatigue levels compared to placebo, with a low risk of bias in all domains 1.
From the Research
Current Status of Melatonin in Cancer Treatment
The current status of melatonin use in cancer treatment is summarized as follows:
- Melatonin has been found to possess potent antioxidant, antiproliferative, immune-modulating, and hormone-modulating properties, which may have a possible role in the treatment of cancer 2.
- Clinical evidence suggests that melatonin may benefit cancer patients who are also receiving chemotherapy, radiotherapy, supportive therapy, or palliative therapy by improving survival and ameliorating the side effects of chemotherapy 2, 3.
- The exact mechanisms behind the anticancer effects of melatonin remain unclear, and the specific characters impede its in vivo investigation 4.
- Melatonin has been found to inhibit the initiation, progression, and metastasis of cancer, and its co-administration improves the sensitivity of cancers to inhibition by conventional drugs 5.
- Melatonin also inhibits molecular processes associated with metastasis by limiting the entrance of cancer cells into the vascular system and preventing them from establishing secondary growths at distant sites 5.
Benefits of Melatonin in Cancer Treatment
The benefits of melatonin in cancer treatment include:
- Improved 1-year survival rate 2, 3
- Improved complete and partial remission rates 3
- Reduced radiochemotherapy-related side effects, including thrombocytopenia, neurotoxicity, and fatigue 3
- Antioxidant activity, modulation of melatonin receptors MT1 and MT2, stimulation of apoptosis, regulation of pro-survival signaling and tumor metabolism, inhibition on angiogenesis, metastasis, and induction of epigenetic alteration 6
Potential Applications of Melatonin in Cancer Treatment
The potential applications of melatonin in cancer treatment include:
- Adjuvant therapy for cancer to improve tumor remission, 1-year survival, and alleviation of radiochemotherapy-related side effects 3
- Prevention and treatment of several cancers, such as breast cancer, prostate cancer, gastric cancer, and colorectal cancer 6
- Utilization as an adjuvant of cancer therapies to reinforce the therapeutic effects and reduce the side effects of chemotherapies or radiation 6