Zamzam Water in Cancer and Beyond: Preclinical Cellular Effects and Proposed Mechanistic Hypotheses

Zamzam water (ZW), a naturally occurring alkaline mineral water with a distinctive ionic and trace-element composition, has attracted growing scientific interest due to its reported pharmacological properties and emerging biological effects relevant to cancer research. This review provides a comprehensive mechanistic synthesis that links the physicochemical characteristics of ZW to molecular and cellular processes implicated in cancer biology. Integrating evidence from cancer biology, redox pharmacology, mitochondrial physiology, and cellular signaling, this review examines how the unique mineral composition and mildly alkaline pH of ZW may collectively influence pathways associated with the hallmarks of cancer. Preclinical studies demonstrate context-dependent modulation of cell proliferation, apoptosis, oxidative stress, mitochondrial function, cell-cycle progression, and signaling pathways, including mitogen-activated protein kinase (MAPK) and cyclic AMP (cAMP) networks, across multiple cancer models. Beyond its reported antiproliferative activity, ZW also exhibits antioxidant, anti-inflammatory, and organ-protective effects in non-malignant systems. Importantly, this review proposes a conceptual framework for investigating the relative contributions of mineral ions, ionic homeostasis, redox regulation, and physicochemical properties to the biological effects of ZW, and identifies key mechanistic and methodological gaps. ZW has exhibited cancer-associated biological effects in experimental animals; however, its therapeutic effectiveness has yet to be validated. Future studies integrating standardized physicochemical characterization, molecular validation, multi-omics approaches, and clinical investigations are required to establish its translational relevance in complementary oncology.