# A Comprehensive Review of Stingless Bee Products:
## 2 Stingless Bee Honey
### Anticancer Potential of Stingless Bee Honey  
In the context of cancer treatment, once it has been diagnosed most cancer cannot simply be removed surgically, but rather requires destructive radiotherapy or chemotherapy. Both methods could result in many unfavourable severe side effects for patients and in worst-case scenarios, some cancer cells have evolved to resist current chemotherapeutic agents [67]. Thus, finding a novel approach to treating cancer is important. The interest in using natural products is increasing due to the trend of researchers seeking new substances that could treat cancer and extend the life expectancy of patients [68]. In preventing cancer, it has been recommended to take honey produced by bees. Inflammatory cells are well-known controls of a cancer environment; thus, inflammation is crucially important to reduce cancer progression [3]. In recent years, reports about using stingless bee honey in treating cancer cells have been scarce. Table 4 shows compiled reports concerning the potential of stingless bee honey anticancer properties. Oral squamous cell carcinoma (OSCC), as shown in Figure 2, is a pathological type of oral cancer, and it is ranked the eighth most common cancer in the world, as it comprises 90% of oral cancers and 5% of all cancers per year [69]. A recent study by [PERSON] et al. [70] on stingless bee honey for treating OSCC showed promising results as a novel treatment. The study used honey from Malaysian _Hetertorigona itama_ stingless bees against an OSCC cell line, HSC-2. Results from a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay showed that inhibition of 50% HSC-2 only needed a 0.84% honey dose, whereas for the maximum inhibition of the cells it only needed a 10% honey dose. The author suggested that the anti-cancerous property of the honey may be due to the presence of phenolic and flavonoid compounds. According to [PERSON] and [PERSON] [72], breast cancer can be divided into three types: hormone receptor-positive breast cancer, which has either an estrogen receptor (ER) or progesterone receptor (PR) protein in the cancer cells; ERBB2-positive, which has high levels of ERBB2 proteins in the cancer cells; and lastly, triple-negative breast cancer, which does not have ER, PR, or ERBB2 protein in the cancer cells. [PERSON] et al. [46] found that stingless bee honey could be use to treat breast cancer. Two breast cancer cell lines were tested--MDA-MB-231 and MCF-7--using an MTT assay. The ideal stingless bee honey samples tested showed the greatest cytotoxic activity towards ER- and PR-positive cells (MCF-7) compared to triple-negative breast cancer cells (MDA-MB-231). Malignant gliomas are the most common form of primary brain tumours and aggressive tumours, with a survival rate of usually up to 15 months after diagnosis. Over the past years, with advances in cytotoxic therapy regimens, targeted angiogenesis inhibitors, and novel therapeutic modalities, diagnosed patient survival has only increased modestly [73]. Figure 2: Oral squamous cell carcinoma on human tongue. Reprinted with permission from Ref. [71]. 2017, Dental Update. Recently, a study by [PERSON] et al. [68] using stingless bee honey to combat malignant glioma showed positive results. The study used a _Heterotrigona itama_ honey against malignant glioma cell line U-87 MG. Results from the cytotoxic activity showed that the highest cytotoxic effect was at a 10% dose of stingless bee honey with inhibition of 50% of U-87 cells. The author stated that the inhibition ability of honey depends on the bee product source, species, and type of cancer line used. Colorectal cancer is one of the most dreadful diseases, and the management of this cancer mainly includes surgical treatment, chemotherapy, and radiation therapy. However, all of these options affect normal cells and cause many side effects [74]. Even in advancing preventative strategies, screening programmes, and chemotherapy, the survival of a patient diagnosed with metastatic colon cancer is only around 20 months [75].