Fruit of His Labor

An ongoing study of noni is showing intriguing results.

 “It’s horrible,” laughs Dr. Brian F. Issell, describing the smell of ripe Morinda citrifolia, otherwise known as noni. Issell, a researcher and professor of medicine at the Cancer Research Center of Hawaii, at the University of Hawaii at Manoa, is willing to look past the stench in the name of science. “Cancer patients often have pain and fatigue,” says Issell, an oncologist. “They would ask, ‘I hear that noni is helpful; what do you think?’ And I’d say, ‘I really don’t know.’"

But he’s well equipped to find out. Issell used to work with Bristol Myers Squibb, developing cancer drugs derived from plants. His noni project, funded by a $340,000 grant from the National Institutes of Health, is a Phase 1 study; the goal is to find the most helpful dosage level. The subjects include 42 late-stage cancer patients; people who have exhausted conventional therapies. “It’s a good mix,” says Issell of the study volunteers. They are evenly split between men and women, and represent a variety of ethnicities. Seven are Native Hawaiians.

“This is one of the first Phase 1 studies that looks at quality of life; it’s unusual,” explains Issell. “This means asking patients, ‘How are you feeling?’ ‘How are you functioning?’ ‘What is your fatigue level like?’” He sees every patient personally, and to gather and process the data, relies on a team that includes a pharmacologist, a social psychologist, research associates, a study coordinator, a statistician and UH students.

Patients take a commercially available brand of dehydrated noni capsules. “We needed to have one standard product and have all the specifications,” Issell explains. “We’re now up to patients taking 24 capsules a day, and we’re going to keep going, because we’re seeing something we didn’t expect to see: We haven’t determined any real toxicity. Usually you come very quickly to a limiting dose.” As a result, the study has taken about two more years than anticipated.

The findings are exciting. “We found that there’s a consistent improvement in function and quality of life at each higher dose,” says Issell. “I don’t know what it means yet. It’s quite dramatic. I can’t show you yet that this is all due to noni. We have to do the study with a placebo. Fortunately, I’ve just heard that we’ve got some money to continue from the Hawaii Community Foundation. Once we get the dosage, we go back to the National Institutes of Health [to fund a placebo study].”

With about 40 percent of his patients taking non-prescribed supplements, Issell is careful with their hopes. “If they feel it’s helping, I tell them that’s fine. But I want to make sure it’s actually helping. Part of it is the act of doing something to help yourself. One of the things that characterizes cancer is that you feel like there’s so much out of your control. When someone is sick, everyone wants to help. Everyone is sort of grasping for things that might be useful. And the only way we’ll know is to do a proper scientific study.”