Study finds Manuka honey does not decrease pain of radiation-induced aesophagitis for lung cancer patients

Research data indicates that when Manuka honey is prescribed for aesophagitis pain during radiation therapy (RT), it is not more effective than standard medical care, according to research presented at the American Society for Radiation Oncology's (ASTRO's) 56th Annual Meeting, which takes place in San Francisco from 14 to 17 September.

Aesophagitis, inflammation that damages tissues of the aesophagus and causes discomfort, is a common and temporary side effect experienced by the majority of lung cancer patients undergoing RT. Small studies have previously been conducted to evaluate if honey can prevent the loss of the normal surface of the mouth or throat caused by RT.

This study assessed the use of Manuka honey, a honey from New Zealand that is a standardised, medical grade honey. The randomised, Phase II trial enrolled 163 lung cancer patients at 13 cancer centres who were undergoing concurrent chemotherapy and RT. Of the study group, ≥30% of the patients had received 60 Gy of RT to the aespophagus (V60).

After four weeks of RT treatment with and without Manuka honey, patients were asked to assess their pain during swallowing using the Numerical Pain Rating Scale (NPRS) scale. The study concluded that there was no significant difference in levels of pain reported by patients within the three groups. Additionally, researchers evaluated secondary endpoints, such as the trend of the patients' pain over time, opiod use, adverse events, weight loss, quality of life, dysphagia and nutritional status. There were no differences in any of the secondary endpoints.

'The results from our study were somewhat unexpected since three previous trials had indicated that honey worked, and reducing aesophagitis is important so that patients can continue eating their normal diet,' said lead study author Lawrence Berk, MD, chief of radiation oncology, Morsani School of Medicine at the University of South Florida, Tampa.

'A larger trial was just completed in Canada for a similar problem – mouth and throat pain during head and neck RT – and that trial also found no benefit with the honey. Both the Canadian study and our trial used Manuka honey, whereas previous trials all used a local honey. This is often a problem in using natural products – each batch or type of product may be different, so it is hard to reproduce the effects seen by others. Currently, honey cannot be recommended for every patient to use for esophagitis pain relief. However, it is safe and inexpensive, so if patients want to try it, there is probably little harm. Patients with diabetes should be cautious with honey because it does have a high sugar load.'