Soursop: what the cancer trials actually measured

Most people arrive here because of cancer, so here is everything that has been measured in humans. One trial has ever given soursop to people with cancer. It enrolled 30 outpatients whose colorectal tumour had already been cut out, ran eight weeks on a leaf extract, and measured whether their blood killed cancer cells in a dish. It never measured a tumour. The public trial registry holds three oncology studies in all, and none of the three has reported a result about a tumour. The one that registered real tumour endpoints, 54 people across six cancers, has said nothing since February 2021. A 2022 systematic review of soursop for high blood sugar turns out to contain no human studies of any kind. So the position is exact, and it is worth stating slowly. Nobody has measured what soursop does to a tumour in a person. There is no study that looked and found nothing, and no study that looked and found something. The measurement has not been made.

The numbers, per 100 g

How much is actually in it

• Two soursop products can share a name and share almost nothing else. What is in them depends on where the plant grew, when it was picked, which part was used and how it was extracted. — Annona muricata preparations used in food supplements (n = about 200 bioactive secondary plant compounds described from Annona muricata, the most abundant class being annonaceous acetogenins, followed by alkaloids, flavonoids and phenols) Evidence E source
  The composition of preparations may differ considerably depending on conditions of plant growth, conditions of harvest, part of plant used, method of extraction and further processing; reliable toxicological data, human studies and toxicokinetic in vivo data are lacking for the specific food supplement products actually on the market

What a real portion looks like

• Soursop is missing from the food data we rely on. The American portion database knows only the nectar drink, the British composition tables do not have it, and neither does the variability dataset or the cooking loss table. — soursop as a food item in reference datasets (n = FNDDS 5,432 foods and 22,046 measures; CoFID 2,886 foods; Foundation Foods 395 foods; retention table 270 group-by-method combinations) Evidence E source
  FNDDS holds exactly one soursop entry, Soursop, nectar (fdc_id 2709350, FNDDS code 64221010), classified as a fruit drink, with measures of 248 g for quantity not specified, 31 g per fluid ounce without ice and 23 g per fluid ounce with ice; CoFID returns nothing for soursop, the variability layer returns nothing, and the retention table has no method for it

What your body absorbs

• Annonacin, the main active compound in soursop, reaches the brain. Given to rats for four weeks it built up in brain tissue, ran the energy supply down and killed cells in the areas that Parkinson's disease destroys. — rats, plus wild-type and human tau transgenic mice in a separate one-year oral study of soursop fruit juice (n = animal studies only, no human toxicokinetic data identified) Evidence D source
  After intravenous annonacin over 28 days, annonacin accumulated in the brain parenchyma, decreased brain ATP levels, induced neuropathological abnormalities in the basal ganglia and caused loss of nigral and striatal neurons; a separate one-year oral exposure to soursop fruit juice increased numbers of neurons with phosphorylated tau protein in several brain regions in mice

What cooking and storage change

• People do not eat soursop the way a nutrition table imagines it. They brew the leaves and bark, juice the ripe fruit, and a few boil or steep the seeds, which is the part with the most annonacin in it. — cancer patients in Trinidad using soursop (n = 121 of 150 patients used soursop, all parts of the plant) Evidence C source
  The leaves, bark and seeds were used to make infusions and decoctions, the ripe fruit was eaten raw, juiced or blended, and two patients consumed either boiled or steeped soursop seeds

What it does to your health

• One human trial has ever tested soursop in people with cancer. It enrolled thirty patients whose tumour had already been cut out, ran eight weeks, and measured whether their blood killed cancer cells in a dish. It never measured a tumour. — outpatients with colorectal cancer who had already undergone primary tumour resection (n = 30 enrolled, 14 to extract and 14 to placebo, 28 completing, equally split) Evidence B source
  Ex vivo and clinical measures showed higher cytotoxicity of patient serum against colorectal cancer cell lines in the supplemented group than in the placebo group; the authors state that further research is required on parameters directly related to cytotoxic activity and on nutritional status
• The one thing soursop has actually been tested for in a decent-sized trial is blood pressure, not cancer. Two hundred grams of juice a day for three months lowered systolic pressure against a group that got nothing. — adults with essential prehypertension combined with high-normal serum uric acid, drawn from a 4,190-person population dataset followed since 2007 in Yogyakarta (n = 143 subjects) Evidence B source
  The treatment group drank 2 x 100 g of soursop fruit juice per day and the control group was not treated; the treatment group had significantly lower mean systolic blood pressure across the three examinations, the control group was more likely to have prehypertension, hypertension and high-normal or high uric acid at both 6 and 12 weeks, and under the 2017 ACC/AHA criteria both systolic and diastolic pressure were significantly lower in the treatment group at 12 weeks
• The reason nobody can say whether soursop supplements are safe is stated plainly in the assessment itself. Human intervention studies usable for safety evaluation do not exist, and that gap is what blocks the answer. — Annona muricata food supplement products (n = literature searched across PubMed, Medline, Scopus, Google Scholar and Web of Science to mid-March 2020, including grey literature) Evidence E source
  The assessment records that scientific information from human intervention studies usable for safety evaluation is currently lacking, calls this a major data gap that impedes risk assessment particularly for long-term use at high supplemental doses, and separately records a lack of reliable in vitro and in vivo studies on interactions between Annona muricata preparations and conventional drugs
• There is a systematic review of soursop for high blood sugar, and it contains no human studies at all. It analysed work done in animals, in dishes and in computer models, and ends by asking for research that establishes a dose. — animal, cell and computational models; no human population (n = not stated in the abstract; the abstract reports that methodology and results of the included articles were heterogeneous) Evidence D source
  The hypoglycaemic function was attributed to enzymatic inhibition, stimulation of pancreatic beta cell proliferation and regulation of food-intake-related genes, with effects depending on bioactive compound content, extraction method and the organism consuming it; the review closes by stating the need for further research using established doses according to bioactive compound content

Safety, limits and interactions

• Europe's food safety body looked at soursop supplements and said it could not name a safe amount. Not a high one, not a low one. The data are not there. — consumers of Annona muricata food supplements in the European Union (n = assessment of the published literature on composition, human studies, animal toxicology, in vitro studies and interactions) Evidence E source
  EFSA concluded that substantial uncertainties exist about safe use, that the data give strong indications of neurotoxic potential of certain preparations, and that the shortage of adequate studies, particularly on long-term use, does not currently allow a safe intake level to be established

What people believe that the data does not support

• A 2020 review concluded that soursop has a favourable safety profile, in the same year that Europe's food safety body said no safe amount could be named. The review lists neurotoxic effects among its own findings and calls the profile favourable anyway. — in vitro studies, preclinical animal studies and human studies of any design, in any language (n = review of mixed evidence types, with no count of included human trials given in the abstract) Evidence D source
  The review reports that Annona muricata and its constituents have hepatoprotective, neurotoxic, antinociceptive, anti-ulcerative and chemopreventive effects, notes that doses and durations showing toxicity in animals may not translate directly to humans, judges the included studies to be of medium to high quality, and concludes that the overall outcome suggests a favourable safety and tolerability profile
• The FDA has written to a soursop seller to say that capsules, tea bags and leaves sold to treat cancer are unapproved new drugs. The letter quotes the seller's own words back, including a promise about twenty laboratory tests. — marketed soursop capsules, tea bags and leaves in the United States (n = one warning letter; FDA maintains a separate public list of illegally sold cancer treatments) Evidence E source
  FDA determined that the products are not generally recognized as safe and effective for the referenced uses and are therefore new drugs under section 201(p) of the Act; among the claims cited were that graviola has proven to be an immensely potent cancer killer in 20 independent laboratory tests

Who this works differently for

• On Guadeloupe, where soursop is eaten daily, most parkinsonism is not ordinary Parkinson's disease. Patients with the two unusual forms had eaten significantly more soursop than either healthy controls or patients with the ordinary kind. — parkinsonian patients on Guadeloupe, where only about a third of parkinsonism presents as classical idiopathic Parkinson's disease (n = 160 parkinsonian patients) Evidence C source
  Patients were classified as Parkinson's disease 31%, Guadeloupean PSP-like syndrome 32%, Guadeloupean parkinsonism-dementia complex 31% and other 6%; consumption of soursop was significantly greater in both the PSP-like and the parkinsonism-dementia groups than in controls and in Parkinson's disease patients, and both atypical groups showed levodopa-resistant parkinsonism with cerebral atrophy and marked T2-hypointensity in the substantia nigra
• Among cancer patients in Trinidad who used any herbal remedy, four in five used soursop. Nearly a third thought it worked as well as their actual treatment, and one in seven thought it worked better. — prostate, breast and colorectal cancer patients attending specialty oncology clinics in Trinidad who reported using herbal remedies or functional foods (n = 150 patients reporting use) Evidence C source
  Soursop was the most popular remedy, used regularly by 80.7% of these patients, who used the leaves, bark, fruit and seeds; remedies were used daily, and patients rated this modality as equally efficacious as conventional treatment in 32.0% of cases and more efficacious in 14.7%

The bottom line

The one thing soursop has a decent-sized human trial for is blood pressure. Two hundred grams of juice a day for three months lowered systolic pressure in 143 adults with prehypertension and high-normal uric acid. The control group was given nothing at all, so that design cannot separate the juice from the attention, and the abstract never states the effect in millimetres of mercury. Safety has to be said carefully in both directions. Europe's food safety body reviewed soursop supplements in 2020 and could not name a safe intake, high or low, because the human studies such a limit is built from do not exist. It also recorded strong indications of neurotoxic potential in certain preparations. That is not proof of harm, and it is not reassurance either. In the same year a systematic review concluded that soursop has a favourable safety and tolerability profile, having listed neurotoxic among its own findings on the way there. The concern comes from annonacin, the main acetogenin in the plant. Given to rats it built up in brain tissue, ran the energy supply down and killed neurons in the areas Parkinson's disease destroys. On Guadeloupe, where soursop is eaten daily, only about a third of parkinsonism is ordinary Parkinson's disease, and patients with the two unusual forms had eaten significantly more soursop than controls or than patients with the ordinary kind. That is a cross- sectional finding and not proof of cause. The seeds carry the most annonacin, and in one survey people were boiling and steeping them. That survey matters for a second reason. Among cancer patients in Trinidad who used any herbal remedy, four in five used soursop, nearly a third rated it as good as their actual treatment and one in seven rated it better. These are people attending oncology clinics, and the same European assessment records that reliable studies of how soursop interacts with conventional drugs do not exist. If you are being treated for cancer, that is the sentence to take to your oncologist. The FDA has written to a seller to say that capsules, tea bags and leaves sold to treat cancer are unapproved new drugs, quoting back the promise that graviola proved itself an immensely potent cancer killer in twenty independent laboratory tests. Laboratory tests are dishes. There are no people in them.

Sources

1. srs-f-05 · agency risk assessment
   Regarding A. muricata preparations that might be used in food supplements, the composition of such preparations may differ considerably, depending, among others, on conditions of plant growth, conditions of harvest, part of plant used, method of extraction and further processing of the preparation.
   EFSA Journal (EU-FORA fellowship report), 2020 · checked 2026-09-21
2. srs-f-13 · reference dataset
   FNDDS 2709350 Soursop, nectar (64221010, Fruit drinks) — Quantity not specified 248 г · 1 fl oz (no ice) 31 г · 1 fl oz (with ice) 23 г · 1 fl oz (NFS) 31 г || CoFID «soursop»: нічого || variability «soursop»: нічого || retention «soursop»: жодного методу
   USDA FNDDS 2021-2023, FoodData Central; CoFID 2021, Public Health England / OGL v3.0; USDA Table of Nutrient Retention Factors R6 · checked 2026-09-21
3. srs-f-07 · animal toxicology summarised in an agency assessment
   For instance, after i.v. application of annonacin over 28 days to rats, annonacin accumulated in the brain parenchyma, decreased brain ATP levels, induced neuropathological abnormalities in the basal ganglia and loss of nigral and striatal neurons in exposed animals (Champy et al., 2003).
   EFSA Journal (EU-FORA fellowship report), 2020 · checked 2026-09-21
4. srs-f-09 · cross-sectional survey
   The leaves, bark and seeds were used to make infusions and decoctions, and the ripe fruit was eaten raw, juiced or blended. Two patients consumed either boiled or steeped soursop seeds.
   Clement et al., BMC Complementary and Alternative Medicine, 2016 · checked 2026-09-21
5. srs-f-01 · randomised double-blind placebo-controlled trial
   Thirty outpatients with colorectal cancer who had undergone primary tumor resection were enrolled in a randomized double-blind placebo- controlled pre-post-trial...Ex vivo and clinical studies showed higher cytotoxicity in the supplemented group compared with the placebo group. Further research is required to investigate the long-term effect of A.muricata leaf extract, particularly on parameters directly related to cytotoxic activity toward colorectal cancer cells and nutrition status.
   Indrawati et al., Asia Pacific Journal of Clinical Nutrition, 2017 · checked 2026-09-21
6. srs-f-02 · randomised controlled trial
   For a 3-month period, the treatment group was given 2 × 100 g soursop fruit juice per day and the control group was not treated...We conclude that soursop supplementation can lower BP and SUA levels.
   Journal of Human Hypertension, 2020 · checked 2026-09-21
7. srs-f-04 · agency risk assessment
   Regarding the use of A. muricata in food supplements, scientific information from human intervention studies, which might be used for safety evaluation of A. muricata, is currently lacking. This represents a major data gap that impedes risk assessment, especially in the case when long-term use of high supplemental A. muricata doses is intended...There is also a lack of reliable in vitro and in vivo studies with respect to potential interactions between A. muricata preparations and conventional drugs.
   EFSA Journal (EU-FORA fellowship report), 2020 · checked 2026-09-21
8. srs-f-11 · systematic review of non-human studies
   In vivo, in vitro, and in silico studies were analyzed in the PubMed database following the strategies proposed by the PRISMA guidelines...Therefore, this review exhibits the necessity of further research, using established doses according to the bioactive compounds content in A. muricata.
   Martin Del Campo-Rayas et al., Journal of Medicinal Food, 2022 · checked 2026-09-21
9. srs-f-03 · agency risk assessment
   The results of the assessment show that substantial uncertainties exist regarding the safe use of A. muricata-based food supplements. The present data provide strong indications of neurotoxic potential of certain A. muricata preparations. However, the paucity of adequate studies, particularly related to long-term use of A. muricata supplements, currently does not allow the establishment of a safe intake level.
   EFSA Journal (EU-FORA fellowship report), 2020 · checked 2026-09-21
10. srs-f-10 · systematic review of mixed evidence
    The results suggest that A. muricata and its constituents have hepatoprotective, neurotoxic, antinociceptive, anti-ulcerative and chemopreventive effects...The overall outcome of the current review suggests that A. muricata has a favourable safety and tolerability profile.
    Chan et al., Journal of Pharmacy and Pharmacology, 2020 · checked 2026-09-21
11. srs-f-12 · regulatory enforcement action
    are not generally recognized as safe and effective for the above referenced uses and, therefore, these products are...Graviola has proven to be an immensely potent cancer killer in 20 independent laboratory tests
    US FDA, Warning Letter to Amazing Sour Sop, Inc., 512798, 17 April 2017 · checked 2026-09-21
12. srs-f-06 · cross-sectional study
    Consumption of soursop was significantly greater in both PSP-like and PDC patients than in controls and Parkinson's disease patients.
    Lannuzel et al., Brain, 2007 · checked 2026-09-21
13. srs-f-08 · cross-sectional survey
    Among the 150 patients who reported use of herbal remedies/functional foods, soursop (Annona muricata L.) was the most popular; with 80.7 % using the leaves, bark, fruit and seeds on a regular basis...Herbal remedies and functional foods were used on a daily basis and patients believed that this modality was equally (32.0 %) or more efficacious (14.7 %) than conventional treatment.
    Clement et al., BMC Complementary and Alternative Medicine, 2016 · checked 2026-09-21