Cancer Research
Pau d'Arco and Cancer: Exploring the Research & Evidence
Important disclaimer
This article is for educational purposes only and is not medical advice. These statements have not been evaluated by the Food and Drug Administration. Pau d'Arco is not intended to diagnose, treat, cure, or prevent any disease. We summarize published research and traditional use — this is not a recommendation to use Pau d'Arco for any specific condition. Always consult a qualified healthcare professional before starting a new supplement, especially alongside an existing medical condition or medication.
For decades, the inner bark of the Pau d'Arco tree (Tabebuia impetiginosa) has been a subject of scientific scrutiny. Often referred to as the "divine tree" by South American indigenous cultures, its traditional use spans centuries. In the mid-20th century, that traditional use caught the attention of oncology researchers — and it's been studied, in different forms, ever since.
This article separates what's actually been studied from what's just repeated online. Every finding below is tagged by evidence type, because "researchers are studying X" and "X treats cancer in people" are very different claims, and conflating them is exactly what makes health content on the internet untrustworthy.
The Power of Lapachol and Beta-Lapachone
The primary interest in Pau d'Arco's studied antitumor activity centers on two naphthoquinones: lapachol and beta-lapachone. Both were isolated in the 1960s and became the focus of early National Cancer Institute (NCI) research.
1968 studies found lapachol showed significant activity against Walker 256 carcinosarcoma in rats, which is what first drew NCI attention to the compound.
Source: Cancer Research (1968)
When researchers moved to Phase I human trials using isolated, high-dose lapachol, the trial was discontinued — the plasma levels needed for antitumor activity could not be reached without dose-limiting toxicity, and lapachol also showed anticoagulant (anti–vitamin K) activity. This is a study that stopped because of the isolated compound's pharmacology, not one that demonstrated a treatment benefit in people.
Source: Cancer Chemotherapy Reports (1974)
Research attention later shifted to beta-lapachone, which lab studies describe as more selective for cancer cells while leaving healthy cells relatively untouched. According to a review in Molecules, beta-lapachone interacts with an enzyme called NQO1, which is often overexpressed in several human cancers, including breast, lung, and colorectal types — in laboratory cell models.
Apoptosis: Programmed Cell Death, in Cell Lines
One heavily studied mechanism is beta-lapachone's ability to trigger apoptosis (programmed cell death) in cancer cell lines grown in a lab — cells naturally "self-destruct" when damaged, and cancer cells often bypass that process.
Cell-line studies report beta-lapachone triggering cell death in NQO1-positive breast cancer cells and inducing extensive DNA damage in non-small-cell lung cancer lines, and whole-bark Tabebuia impetiginosa extract inhibiting growth of breast, lung, cervical, and liver carcinoma lines without toxicity to non-tumour cells. These are laboratory (in vitro) cell-culture results, not outcomes observed in cancer patients.
Source: PNAS (2007); Scientific Reports (2017); Molecules (2015)
Metastasis and Angiogenesis Signaling, in Lab Models
Beyond cell death, some research has looked at whether Pau d'Arco compounds affect the AKT1/mTOR signaling pathway — a pathway that's often hyperactive in cancer and tied to both tumor growth and the chronic inflammation covered in our Pau d'Arco and Inflammation article.
Laboratory research suggests beta-lapachone can inactivate the Akt/mTOR pathway and suppress epithelial-to-mesenchymal transition in NQO1-positive cancer cell models, which theoretically limits a tumor's ability to recruit blood supply and spread. This is pathway-level, cell-model research — it has not been demonstrated as a clinical effect in humans.
Source: Scientific Reports (2017)
More Recent Laboratory and Animal Research
Pending medical review. This section was added on September 26, 2026 and has not yet been reviewed by our medical reviewer.
Newer papers keep testing beta-lapachone and lapachol against a wider range of cancer models. Every result below comes from cells in a dish or from animals given the isolated compound or an extract. None of it has been shown in people who drink the tea.
In cervical cancer cell lines, beta-lapachone reduced proliferation and metastasis-related behavior, lowered signs of new blood-vessel formation, and suppressed epithelial-to-mesenchymal transition (EMT), specifically in cells with high NQO1 expression. Network analysis pointed to AKT1 and inactivation of the PI3K/AKT/mTOR pathway as the likely mechanism. The authors also checked effects and toxicity in a nude-mouse xenograft model, so this is laboratory and animal-model research.
Source: Frontiers in Pharmacology (2025)
In 3D spheroids grown from MCF-7 breast cancer cells, beta-lapachone reduced spheroid size and cell viability in a dose-dependent way (about 25% at 1.2 mg/L after 48 hours, and up to about 50% at higher concentrations), slowed cell migration, and shifted two EMT markers: E-cadherin rose by 18.4% and vimentin fell by 34.3%. These are cell-culture results at concentrations applied directly to the cells.
Source: BMC Cancer (2025)
In bladder cancer cell lines, lapachol reduced cell viability and colony formation, slowed migration, and produced cell-cycle changes consistent with apoptosis. It also changed the expression of some long non-coding RNAs, in a way that differed between cell lines. This is the isolated compound applied to cultured cells, not tea.
Source: Scientific Reports (2025)
In murine colon cancer cells, beta-lapachone induced apoptosis and cell-cycle arrest and reduced migration and invasion. In a mouse experimental-metastasis model, it significantly inhibited lung metastasis of the CT26 cells. This is an animal model using the isolated compound.
Source: Integrative Cancer Therapies (2016)
In mice bearing Ehrlich ascites tumours, a Tabebuia avellanedae bark extract (30–500 mg/kg) and beta-lapachone (1–5 mg/kg) reversed the tumour-associated disruption of bone-marrow progenitor cells (CFU-GM) in a dose-dependent way. The optimal doses (120 mg/kg of extract, or 1 mg/kg of beta-lapachone) also prolonged the survival of the tumour-bearing mice, while higher beta-lapachone doses produced toxic effects. Notably, the extract doses used contained no detectable beta-lapachone, and the authors suggested the effect may involve macrophage activation. Rodent results like these are often more dramatic than what happens in people, and this is not evidence that the tea affects bone marrow or cancer.
Source: Journal of Ethnopharmacology (2008)
Modern Clinical Research: ARQ 761
Much of the early lapachol research was set aside because of the isolated compound's side effects. More recently, a synthetic beta-lapachone analogue called ARQ 761 has entered clinical testing.
ARQ 761 has been studied in a Phase 1 trial in patients with advanced solid tumors, aimed at establishing safety and dosage using a more refined understanding of the NQO1 mechanism than the 1970s trials had. Phase 1 trials test safety, not proven effectiveness — ARQ 761 is not an approved treatment and is not the same substance as Pau d'Arco tea.
Source: British Journal of Cancer (2018) — Phase 1 trial
What Memorial Sloan Kettering Says
Pending medical review. This section was added on September 26, 2026 and has not yet been reviewed by our medical reviewer.
Memorial Sloan Kettering's herb summary reports that small studies suggested a lapacho-based preparation may help prevent oral mucositis (painful mouth sores) in people with head and neck cancer undergoing radiotherapy, and describes that evidence as preliminary. The same page reports that lapachol did not show clinical improvement in patients with chronic myelocytic leukemia, and warns that pau d'arco may increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs. We are relaying MSK's summary. We have not independently reviewed the underlying studies, and a "lapacho-based preparation" is not necessarily brewed tea.
Source: Memorial Sloan Kettering Cancer Center, About Herbs: Pau d'Arco
Whole Bark vs. Isolated Compounds
A recurring theme in herbal research is the difference between an isolated chemical compound and the whole plant as traditionally prepared.
Historical accounts suggest that while isolated, concentrated lapachol caused side effects in 1970s trials, whole bark extract contains other phytochemicals that traditional preparation methods have relied on for generations without the same reported toxicity. This is traditional-use evidence, not a controlled clinical comparison.
Source: Rain-Tree Tropical Plant Database; traditional-use records
Because the active naphthoquinones are not highly water-soluble, traditional preparation uses a decoction (simmered, not just steeped) to extract them effectively. If you're sourcing bark to prepare this way, our inner bark sourcing guide covers what to look for — we source our own reference-grade Pau d'Arco through Taheebo Wellness Tea.
How to Prepare a Pau d'Arco Decoction
- Measure — 3 tablespoons of fine-grind Pau d'Arco inner bark per 4½ cups of water.
- Boil — in a stainless steel or glass pot (avoid aluminum).
- Simmer — reduce the heat and cook covered at a gentle rolling boil for 25 minutes.
- Strain — through a fine mesh filter.
- Serve — hot or cold.
For antimicrobial-related uses specifically, see our Pau d'Arco and Candida article — the underlying compounds overlap.
Precautions and Considerations
- Toxicity at high doses: isolated lapachol can cause nausea, vomiting, and dizziness in excess. Traditional preparation strengths are the relevant reference point, not concentrated isolate doses.
- Anticoagulant effects: Pau d'Arco may have blood-thinning properties and should not be combined with blood-thinning medication (e.g., Warfarin) or used before scheduled surgery without medical guidance.
- Pregnancy and breastfeeding: not recommended — some compounds have shown potential effects on fetal development in animal studies.
- Sourcing quality: many commercial products use outer bark or different species, which lack the same concentration of studied compounds as true inner bark.
Where This Leaves Us
The honest summary: Pau d'Arco's naphthoquinones have been studied repeatedly in cancer-cell and animal models, and one derivative (ARQ 761) has reached early-stage human clinical trials. None of that adds up to a treatment claim for drinking the tea — robust human clinical trials on Pau d'Arco tea itself, in cancer patients, don't yet exist. If you're evaluating Pau d'Arco alongside a cancer diagnosis, that decision belongs with your oncologist, not a wellness article. What the research supports today is scientific interest, not a substitute for medical care.
See our FAQ for sourcing and preparation questions, or the About & Methodology page for how we select and grade the research we cite.
References
- 1.Rao, K.V., McBride, T.J., Oleson, J.J. (1968). "Recognition and Evaluation of Lapachol as an Antitumor Agent." Cancer Research.
- 2.Block, J.B., et al. (1974). "Early clinical studies with lapachol (NSC-11905)." Cancer Chemotherapy Reports, Part 2.
- 3.Ferraz da Costa, D.C., et al. (2020). "Anticancer Potential of Resveratrol, β-Lapachone and Their Analogues." Molecules.
- 4.Zhang, J., et al. (2020). "Tabebuia impetiginosa: A comprehensive review on traditional uses, phytochemistry, and immunopharmacological properties." Molecules.
- 5.Bey, E.A., et al. (2007). "An NQO1- and PARP-1-mediated cell death pathway induced in non-small-cell lung cancer cells by β-lapachone." PNAS.
- 6.Yang, Y., et al. (2017). "β-lapachone suppresses tumour progression by inhibiting epithelial-to-mesenchymal transition in NQO1-positive breast cancers." Scientific Reports.
- 7.Pires, T.C.S.P., et al. (2015). "Bioactive Properties of Tabebuia impetiginosa-Based Phytopreparations and Phytoformulations: A Comparison between Extracts and Dietary Supplements." Molecules.
- 8.Gerber, D.E., et al. (2018). "Phase 1 study of ARQ 761, a β-lapachone analogue that promotes NQO1-mediated programmed cancer cell necrosis." British Journal of Cancer.
- 9.Journal of Ethnopharmacology (2008): "Comparative studies of the effects of Tabebuia avellanedae bark extract and beta-lapachone on the hematopoietic response of tumour-bearing mice."
- 10.Integrative Cancer Therapies (2016): "β-Lapachone Inhibits Lung Metastasis of Colorectal Cancer by Inducing Apoptosis of CT26 Cells."
- 11.Frontiers in Pharmacology (2025): "β-lapachone suppresses carcinogenesis of cervical cancer via interaction with AKT1."
- 12.Scientific Reports (2025): "Lapachol interferes with the cell cycle and inhibits proliferation and migration of bladder tumor cells with effects on ncRNA expression."
- 13.BMC Cancer (2025): "β-lapachone impairs viability, migration, and epithelial-mesenchymal transition in mammary tumor spheroids."
- 14.Memorial Sloan Kettering Cancer Center, About Herbs: "Pau d'Arco."
Reviewed by
Carol Wade, RH (AHG) — Clinical Herbalist, Ojai School of Herbal Studies