Potential Molecular Mechanisms of Ginsenosides for Alleviating Cancer-Related Fatigue and Clinical Research Progress of Ginseng Preparations: A Review

Cancer-related fatigue (CRF) is a persistent, subjective symptom experienced by patients with cancer over the course of the disease and its treatment. It can substantially impair patients’ quality of life, and its pathophysiological mechanisms remain incompletely understood. Ginseng is a traditional Chinese medicinal herb used to tonify qi and alleviate debility associated with prolonged illness. Clinical studies suggest that ginseng preparations may alleviate CRF to some extent. However, substantial heterogeneity among existing studies means that robust and reproducible evidence supporting the efficacy of ginseng in alleviating CRF remains insufficient. Ginsenosides are the major bioactive constituents of ginseng. Studies have reported several pharmacological effects of ginsenosides relevant to CRF, including anti-inflammatory effects and modulation of neuroendocrine function and muscle energy metabolism. These findings suggest that ginsenosides may have the potential to alleviate CRF. This review focuses on three representative ginsenosides (Rg1, Rg3, and Rb1), explores their potential molecular mechanisms in CRF alleviation, and reviews clinical studies of ginseng preparations for CRF management. Based on gaps in the current evidence, this review identifies priorities for future research to inform further studies of ginseng-based interventions for CRF.