THE SYNERGISTIC POTENTIAL OF ALOE RUBROVIOLACEA AND HIBISCUS SABDARIFFA IN CANCER SUPPORTIVE CARE: A COMPREHENSIVE NARRATIVE REVIEW

Background: The escalating global burden of cancer is compounded by the severe, dose-limiting toxicities associated with conventional chemotherapeutics. In regions with constrained healthcare infrastructure, such as Yemen, there is an urgent need for accessible, effective cancer supportive care. Objective: To systematically review the epidemiological landscape of cancer and evaluate the phytopharmacological rationale for utilizing a polyherbal approach—specifically combining endemic Aloe rubroviolacea and Hibiscus sabdariffa—as a supportive botanical intervention in oncology. Methods: A comprehensive literature review was conducted analyzing global and regional cancer statistics, the limitations of current chemotherapies, and the in vitro and in vivo anticancer, immunomodulatory, and antioxidant mechanisms of Aloe and Hibiscus extracts. Discussion: Conventional cancer treatments inevitably cause systemic toxicities, prompting high utilization of complementary and alternative medicine (CAM). Hibiscus sabdariffa exerts potent direct cytotoxic effects, inducing apoptosis via AMPK activation and downregulating pro-inflammatory cytokines. Concurrently, Aloe rubroviolacea offers immense hepatoprotective, immunomodulatory, and free radical scavenging capabilities. Integrating these botanicals theoretically produces a multi-target synergy that mitigates oxidative stress and protects normal tissue without compromising antineoplastic efficacy. Conclusion: The evidence strongly supports the pharmacological viability of combining A. rubroviolacea and H. sabdariffa. Rigorously standardized extracts of these plants hold immense promise as a locally sourced, culturally resonant, and highly effective modality for comprehensive cancer supportive care.