October 22, 2021
Imitating our title from the 2016 book by Marla Uspenski, “Cancer Hates Tea”, we aspire in this article to provide a medical/scientific guide for the research that has been conducted on Manuka honey and its effects on cancer. I am not a qualified medical professional, nor do I have science backgrounds. Therefore, I am not qualified to distill the body of knowledge represented by the studies referenced here into conclusions or specific recommendations. What I can do is summarize and outline the nature of the research that has been conducted, highlight findings that appear consistent across studies and provide a starting point for further inquiry by readers. I appreciate the fact that for anyone currently battling cancer, or anyone with a family member or close friend with a diagnosis, this can be a heavy and scary subject. I approach the subject with the utmost humility and a good faith effort to point to some positive and optimistic signs, versus making bold claims and definitive statements. Does cancer really hate Manuka honey? I think it might, and I encourage you to read on and draw your own conclusions.
In the first paper we included in our appendix, researchers looked at a multitude of previous studies into the links between oxidative stress, the resulting chronic inflammation, and the development and resilience of cancer cells. Referencing over 300 different papers published over two decades, this study appears to be very comprehensive. “Chronic inflammation has been linked to various steps involved in carcinogenesis, including cellular transformation, promotion, survival, proliferation, invasion, angiogenesis and metastasis”. In less scientific terms, this describes how cells mutate, multiply, fail to die like normal cells, spread to different parts of the body, form tumors, etc. Quoting further from the same source, “Therefore, targeting redox-sensitive pathways and transcription factors offers great promise for cancer prevention and therapy. Numerous agents have been identified that can interfere with redox cell signaling pathways [9, 312, 313]. These include neutraceuticals derived from fruits, vegetables, spices, grains, and cereals.” Manuka honey, considered a neutraceutical due to its extensive wellness and healing properties, is actively being studied by research teams for its potential role in preventing, treating and assisting patients undergoing more traditional cancer treatment protocols.
Traditional cancer treatments have limitations on certain types of cancer. Additionally, traditional cancer treatments can have adverse side-effects. These factors seem to be fueling the efforts to find more natural, plant-based products that may help prevent and/or treat and heal cancer patients. In other instances, honey can be a compliment to traditional cancer treatments, helping patients better tolerate those treatments, and/or working synergistically with those treatments. Honey contains Flavonoids and phenolic acids, which researchers believe may be a key source of cancer fighting properties in foods. “Honey is among the most popular natural products which are investigated for anticancer effects.” In the second paper that we point to in our appendix, researchers in 2019 looked at all of the scientific studies they could find, in which research teams tested honey (and in most cases Manuka honey) vs. cancer cell lines. The study references 70 different studies that their team reviewed to compile their paper and draw the following conclusions: “Flavonoids (kaempferol, catechin, and quercetin) and phenolic acids (caffeic acid and gallic acid) are the most important ingredients of honey with known anti-cancer activity. The main suggested mechanisms for anti-cancer activity of honey and its ingredients are antioxidant, apoptotic, tumor necrosis factor inhibiting, antiproliferative, immunomodulatory, anti-inflammatory and estrogenic effects.” In the next sections we’ll explore further some of these anti-cancer mechanisms, pulling examples of evidence that supports the efficacy of Manuka honey where we can.
We looked at two studies that were targeted on Manuka honey’s effect on oxidative stress and chronic inflammation. There is evidence from a 2018 study showing that Manuka honey exhibited a “marked potential” to protect DNA from oxidative damage in whole human blood, in the presence of hydrogen peroxide being used to induce that oxidative stress. In a more expansive study, also from 2018, researchers looked deeply into the question of can Manuka honey protect against oxidative stress and reduce chronic inflammation? The full text of this study is publicly available, it is extensive and scientifically dense. Their conclusion though is direct and encouraging, “In Conclusion, MH acted as a natural agent for preventing oxidative and inflammatory-related diseases.” 
The term apoptotic references the natural programmed cell death that occurs in living organisms. This process of apoptosis can be blocked in cancer cells. Thus, an apoptotic property of honey would be its ability to stimulate cell death in cancer cells. A 2018 study tested the effectiveness of Manuka Honey, combined with 5-fluorouracil (5-FU), a commonly used chemotherapy drug for treating colon cancer. Highlights from the study included, “Manuka honey enhances 5-FU-induced apoptosis, regulating intrinsic and extrinsic pathway.” Manuka honey was also found in this study to have anti-metastasis effects when combined with 5-FU, decreasing the migration of the cancer cells. Further research by this same team, published in two parts that are both referenced in our appendix, confirmed these initial findings of increased promotion of apoptosis and reduced proliferation or suppression of the cell’s metastatic ability. In these further two studies, Manuka honey was tested alone in various concentrations against two different colon cancer cell lines. Part 1 of the study concluded, “Overall, these findings indicate that MH could be a promising preventive or curative food therapy for colon cancer.”
Immunomodulatory, in this context refers to the ability of honey to modulate the body’s immune system. A study published in April of 2021 reviewed all of the cancer studies involving honey with a specific focus on summarizing the evidence for honey’s immunomodulatory properties. The full text of this study is publicly available From the concluding remarks, “The overall net changes induced by honey and its polyphenolic constituents alter the tumor microenvironment, reduce angiogenesis and reprogram immune cells, making them more hostile to the continued growth and metastasis of cancer cells.”
Many of the studies that have been carried out by research teams have either included Manuka honey from New Zealand among a few other honey types, or focused exclusively on Manuka honey. I believe the reason for this has to do with the reputation Manuka honey has developed over the past 30 years due to its anti-bacterial, anti-viral, anti-parasitic and anti-inflammatory properties. It may also be due to the variety of flavonoids and phenolic acids. The 2021 study, discussed above, lists the following as major flavonoids found in Manuka honey: Chrysin, Galangin, Isorhammetin, Kaemperol, Luteolin, Apigenin, Pinobanksin, Pincoembrin and Quercetin. Major phenolic acids include: 2-methoxybenzoic, 2-methoxybenzoic acid, Caffeic acid, Ferulic acid, Gallic acid, p-Couraric acid, and Syringic acid. These are certainly not household names that we are used to looking for on labels at the grocery store, but it is an impressive list and given the assumption that it is these types of compounds that most likely contribute to anti-cancer properties, Manuka honey would seem to be a really logical research candidate.
The majority of the studies that are included as references in our footnotes, or in the appendix of this article, are in-vitro studies. That is, in the lab, testing vs. cell lines. There are some in-vivo studies involving mice and rats. One logical next step for researchers is to begin to understand how effective Manuka honey is after being digested, and to what degree it becomes bio-available throughout the body. One study approached this question by looking at how the digestion of Manuka honey affected its cancer fighting properties. In the study, the team simulated human digestion in the lab, and then compared the efficacy of undigested and digested Manuka honey when treating human colon cancer cells. The full text of this study is publicly available, and it, too, is scientifically dense. It found similar results between the digested and raw Manuka honey, with regards to inhibiting the ability of cancer cell colonies to form, but differences in how the two honeys induced apoptosis and regulated the cell cycle.
One of the studies that really caught my attention was one conducted in 2016, comparing Manuka Honey with Tualang honey (from Malaysia) on breast cancer using rats. The rats were divided into 4 groups as follows: a negative control (no tumor induction); a positive control (no honey treatment); a group fed Tualang honey; and a group fed Manuka honey. Tumors were intentionally induced and the feeding of honey began when the tumors began to be identified. In both the honey treated groups, the tumors that were formed were smaller in weight and volume, and had better histological grades compared to the untreated group. Clearly, for the honey to have helped the rats, it was digested and became available in the bloodstream to be able to impact the breast cancer cells in the tumors.
In our review of the published literature, we found breast cancer (Appendix references 9,10,14,17) and colon cancer (5,6,7,13,15,17) to be the most commonly studied. Often, the frequency of these cancers occurring was given as a reason for their selection as study subjects. In the case of breast cancer, some of the research noted that it was focused particularly on cell lines that were known to be difficult to treat with conventional cancer treatments. Also reviewed were studies on skin cancer (11,17), prostate cancer (16), lung cancer (9) and liver cancer (12).
As promised in the introduction, I’m not making any prescriptive claims about Manuka honey’s ability to prevent, treat or cure cancer. I have a personal anecdote about a malignant biopsy, on a routine skin cancer scan that I treated with Manuka honey about 5 years ago. My doctor agreed to treatment after my next trip to NZ, so 3 months later I dutifully showed up for my follow-up appointment. After extensive arm twisting, I convinced my doctor to do a fresh biopsy prior to starting treatment. The biopsy came back negative and the treatment was avoided. I do believe there is a meaningful body of science building a case for serious consideration being given to Manuka honey’s role in cancer prevention and treatment. I hope this article gives you a sense for the nature of the research work undertaken to-date, as well as a feeling for the encouraging findings from these studies. For those of us blessed with generally good health, perhaps this provides one more argument for incorporating Manuka honey into our daily diet, as a preventative measure against a host of diseases. For those that are actively fighting cancer, or have a loved one that is doing so, I hope this article provides a resource for further research and investigation. Our goal at Bees & Trees is to share with our customers one of nature’s truly amazing foods, in its most raw and unadulterated form. We wish you good health for you today and into the future.
Founder: Mike Everly
A note about the appendix.
For each of the studies that we reviewed in preparing this article, we’ve outlined some basic information about the study and included links to each study. We have noted if only the abstract, or if the full text of the study is available. Some of these links will be to the abstract, and may require clicking on the links under the title for the PMCID or DOI numbers to access the full text of the articles. Where we say that only the abstract is available, we mean for free. Anyone can purchase access to the full text of papers through various services which will be indicated on the abstract page. Don’t hesitate to contact us if you are trying to follow-up on a subject and having difficulty with a link or finding the article and we’ll try to assist. You can email me directly at firstname.lastname@example.org or our main mailbox at email@example.com.
 Reuter S, Gupta SC, Chaturvedi MM, Aggarwal BB. Oxidative stress, inflammation, and cancer: how are they linked? Free Radic Biol Med. 2010 Dec 1;49(11):1603-16. doi: 10.1016/j.freeradbiomed.2010.09.006. Epub 2010 Sep 16. PMID: 20840865; PMCID: PMC2990475.
 Waheed M, Hussain MB, Javed A, Mushtaq Z, Hassan S, Shariati MA, Khan MU, Majeed M, Nigam M, Mishra AP, Heydari M. Honey and cancer: A mechanistic review. Clin Nutr. 2019 Dec;38(6):2499-2503. doi: 10.1016/j.clnu.2018.12.019. Epub 2018 Dec 27. PMID: 30639116.
 Živković L, Bajić V, Dekanski D, Čabarkapa-Pirković A, Giampieri F, Gasparrini M, Mazzoni L, Potparević BS. Manuka honey attenuates oxidative damage induced by H2O2 in human whole blood in vitro. Food Chem Toxicol. 2018 Sep;119:61-65. doi: 10.1016/j.fct.2018.05.034. Epub 2018 May 12. PMID: 29763681.
 Gasparrini M, Afrin S, Forbes-Hernández TY, Cianciosi D, Reboredo-Rodriguez P, Amici A, Battino M, Giampieri F. Protective effects of Manuka honey on LPS-treated RAW 264.7 macrophages. Part 2: Control of oxidative stress induced damage, increase of antioxidant enzyme activities and attenuation of inflammation. Food Chem Toxicol. 2018 Oct;120:578-587. doi: 10.1016/j.fct.2018.08.001. Epub 2018 Aug 2. PMID: 30077706.
 Afrin S, Giampieri F, Forbes-Hernández TY, Gasparrini M, Amici A, Cianciosi D, Quiles JL, Battino M. Manuka honey synergistically enhances the chemopreventive effect of 5-fluorouracil on human colon cancer cells by inducing oxidative stress and apoptosis, altering metabolic phenotypes and suppressing metastasis ability. Free Radic Biol Med. 2018 Oct;126:41-54. doi: 10.1016/j.freeradbiomed.2018.07.014. Epub 2018 Jul 26. PMID: 30056083.
 Afrin S , Giampieri F , Gasparrini M , Forbes-Hernández TY , Cianciosi D , Reboredo-Rodriguez P , Amici A , Quiles JL , Battino M . The inhibitory effect of Manuka honey on human colon cancer HCT-116 and LoVo cell growth. Part 1: the suppression of cell proliferation, promotion of apoptosis and arrest of the cell cycle. Food Funct. 2018 Apr 25;9(4):2145-2157. doi: 10.1039/c8fo00164b. PMID: 29645049.
 Masad RJ, Haneefa SM, Mohamed YA, Al-Sbiei A, Bashir G, Fernandez-Cabezudo MJ, Al-Ramadi BK. The Immunomodulatory Effects of Honey and Associated Flavonoids in Cancer. Nutrients. 2021 Apr 13;13(4):1269. doi: 10.3390/nu13041269. PMID: 33924384; PMCID: PMC8069364.
 Cianciosi D, Forbes-Hernández TY, Afrin S, Gasparrini M, Quiles JL, Gil E, Bompadre S, Simal-Gandara J, Battino M, Giampieri F. The Influence of In Vitro Gastrointestinal Digestion on the Anticancer Activity of Manuka Honey. Antioxidants (Basel). 2020 Jan 10;9(1):64. doi: 10.3390/antiox9010064. PMID: 31936782; PMCID: PMC7023262.
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