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Pattern Names

Cancer • •

Classification
Category: Bio Med	Syndrome: Cancer

BioMed: Cancer diagnosis: surgical biopsy, microscopic exams, Fine Needle Aspirations, Chest X rates, Tumor markers. TNM System is a shorthand system for describing the extent of a particular malignant tumor. T: Extent of primary tumor. N: Presence/extent of regional lymph node metastasis. M: Presence of distant metastasis. Numerical additions indicate the extent of malignant disease (e.g., T0, T1, N0, M0). Treatment include chemotherapy, hormonal therapy, and biologic therapy (BCG, interferons, etc).

Symptoms

Tongue:

Pulse:

Indications: Cancer diagnosis often involves identifying chromosomal abnormalities specific to different cancers, such as monosomy 5 and 7 in acute leukemia or translocation of chromosome 8 in Burkitt’s lymphoma.

Etiology: Pathology of cancer in TCM are 1) Qi, Blood, and Emotional disharmony 2) Toxic Heat pathogens, latent pathogenic factors and fire poisons. 3) Zang Fu deficiencies.

Treatment Principle

Conventional medicine focuses on treating the end stage of cancer with cytotoxic interventions. In contrast, Chinese medicine considers the patient's underlying condition, gradual debilitation, and current deficiencies. • ADDRESSING UNDERLYING DEFICIENCIES: Cancer consumes qi and blood to sustain itself, leading to vital energy deficiencies. Treatment should focus on the cancer cells and the factors causing the initial cellular injury. A strategic intervention requires an adaptive and ongoing treatment plan, eliminating exposures that caused the original injury. This holistic view addresses the root causes of the disease rather than just its symptoms. • INTEGRATION OF WESTERN DIAGNOSTIC TECHNIQUES: Early detection of cancer and precancerous conditions is crucial. Western diagnostic techniques, such as Pap smears, play a significant role in this process, helping monitor and diagnose conditions early to improve patient outcomes. Additionally, laboratory analyses, including blood chemistries and tumor marker monitoring, provide valuable information about the effectiveness of treatments, aiding in formulating and modifying treatment plans. • PHARMACEUTICAL ANALYSIS OF HERBS: Chinese medicine integrates the pharmaceutical analysis of specific herbs to enhance treatment efficacy. Herbs are selected based on their properties and antineoplastic effects. For example, tonic herbs like Huang Qi (astragalus) and Ren Shen (ginseng) have antineoplastic properties, while others like Lu Rong (deer antler) may be contraindicated. SEE TREATMENT PRINCIPLES BELOW. [Lahans, T. (2007). Integrating conventional and Chinese medicine in cancer care: A clinical guide. Elsevier Health Sciences.]

Acupunture

TREATMENT RULES: 1. Alleviate acute symptoms first. This can include everything from referral to the primary oncologist or the emergency room for hemorrhagic bleeding to stopping acute nausea. 2. In very weak patients, treat the symptom picture and the root (constitutional diagnosis) simultaneously. The strength of each prong is determined by the strength of the Zheng qi (resistant qi) in the patient. 3. If the pathogenic factor (the cancer) and the body’s Zheng qi are both weak, tonify the Zheng qi to push out the pathogen (if possible). This is especially important in later-stage disease. 4. If the body’s Zheng qi is weak and the pathogen is strong (i.e. later-stage cancer or a very aggressive cancer), the pathogen must be eliminated without harming the Zheng qi. 5. As the qi, blood and yin become more engaged by the disease, a balance must be struck between eliminating and tonifying. In order to eliminate pathogens from the body adequate Zheng qi is required. In the case of chemotherapy, treatment is eliminative only and without rehabilitative function. In this case, herbal medicine becomes the balancing mechanism in the overall treatment by being almost entirely supportive. 6. Do not do anything to undermine the treatments chosen by patients for themselves.We must honor and respect their own choices and evolve a treatment plan that will accommodate the continued efficacy of treatments from other systems of medicine. 7. Know the mechanism of the conventional treatment being used. The side effects can be treated without undermining the mechanism. Maintaining normal body functions as much as possible is one way of actually enhancing the effectiveness of the cytotoxic therapy. [Lahans, T. (2007). Integrating conventional and Chinese medicine in cancer care: A clinical guide. Elsevier Health Sciences.]

Herbs

FORMULA COMPOSITION: 1. In cancer management, prescriptions are tailored to address both the cancer and the side effects of conventional treatments. This process involves considering factors such as the patient’s constitutional diagnosis, the nature of their cancer, and their current treatment. The goal is to support, rehabilitate, and protect normal function while being anticancer. 2. Before surgery, formulas aim to build blood levels, accelerate tissue regeneration, reduce blood loss and swelling, and prevent cancer spread. Post-surgery, they focus on reducing healing time, scar tissue, and pain while preventing infection. During radiation, formulas protect healthy tissue and enhance the effectiveness of the treatment. Herbs like Dan Shen (Salvia miltiorrhiza) can boost blood circulation to tumors, improving treatment outcomes. 3. During chemotherapy, formulas are customized to match the specific regimen and its side effects, supporting bone marrow, gastrointestinal health, and overall function. For high-dose chemotherapy, especially in Europe, herbal formulas can mitigate side effects and improve prognosis. 4. Formulas are adjusted according to the patient’s evolving needs, addressing tumor load, cancer prevention, immune function, endocrine regulation, organ health, digestion, and conventional treatment effects. Different treatment schedules, like those with Adriamycin, require specific approaches to manage side effects and support recovery. 5. For dose-dense or continuous chemotherapy regimens, a consistent formula may be used. Although administering herbal medicine during hospital stays can be challenging, it can be resumed post-discharge. Building strong relationships with oncologists can enhance the integration of complementary therapies. • FORMULA APPLICATION: Combine TCM and Biomed diagnostics for effective treatment. If unsure about interfacing anticancer herbs with chemotherapy, use them only symptomatically around the chemotherapy period. Avoid using them during infusion. High dose chemotherapy can lead to immune suppression and concerns about infections from herbal contamination. Granulated, irradiated herbs may be safer. Be cautious with crude herbs; ensure proper preparation and avoid contamination from molds or improper cooking. Begin herbal medicine after the initial days of chemo when nausea subsides to prevent negative responses. Doses of cancer patients are typically higher than for non-cancer patients, with daily doses often double or quadruple the normal amount. Frequent dosing may be needed. For patients with low immunity, opt for individually packaged, irradiated herbs to reduce contamination risk. [Lahans, T. (2007). Integrating conventional and Chinese medicine in cancer care: A clinical guide. Elsevier Health Sciences.]

Notes

TREATMENT PRINCIPLES: 1)FU ZHENG QU XIE (扶正祛邪) PRINCIPLE: Fu zheng qu xie is a therapeutic principle in Chinese medicine aimed at enhancing the patient’s immune system and overall body function to eliminate both external and internal pathogenic factors that cause disease. By strengthening the patient’s resistance, this approach seeks to dispel pathogenic factors. The herbs and formulas used in this category act as biological response modifiers (BRMs), potentially allowing for intensified chemotherapy by mitigating its side effects. Fu zheng therapy aims to prevent deficiencies caused by both cancer and conventional treatments like chemotherapy and radiation, which can deplete normal qi. Herbs and formulas in this category help protect the bone marrow, mucosal lining of the gastrointestinal tract, and maintain normal organ function. Fu zheng also emphasizes maintaining the patient's spirit. Patients facing life-threatening diseases can be further harmed by loss of hope, depression, and anxiety, which are addressed as part of maintaining normal qi. Many of these herbs contain high levels of polysaccharides with strong immunopotentiating and antitumor activities. Examples include Ci Wu Jia, Huang Qi, and several mushrooms like Ling Zhi, which inhibit tumor growth, increase white blood cell counts, reduce platelet aggregation, and act as mild analgesics. • 2) HUO XUE QU YU (活血祛瘀) PRINCIPLE: Huo Xue Qu Yu refers to the activation of blood circulation. Blood stasis is a precursor to cancer and is always part of the end result. Masses and tumors are forms of congealed blood, often combined with phlegm and toxins. Blood stasis syndrome features poor microcirculation with abnormal capillary beds, indicated by twisted capillaries, high platelet aggregation, high blood viscosity, high fibrinogen, and disseminated intravascular coagulopathy (DIC). Herbs used to treat blood stasis are categorized into three types: those that nourish the blood and increase volume, those that invigorate the blood by mildly changing its viscosity, and those that strongly change viscosity and break down membranes around tumors. Blood-moving herbs break down the fibrin coating around tumors, improving immune cell access. Tumor cells with poor circulation survive on low oxygen levels, making them less susceptible to radiation. Blood-activating herbs are being studied for their radiosensitizing effects and to potentiate chemotherapy. Regular exercise is crucial for preventing blood stasis. Blood-activating herbs are researched for their ability to change blood viscosity to prevent metastasis. These herbs have direct cancer-inhibiting actions and promote immune surveillance, aiding in the overall treatment and prevention of cancer. • 3) QING RE JIE DU (清热解毒) Qing Re Jie Du focuses on removing heat toxins using clear heat herbs. Heat toxins are agents that transform simple abnormalities into severe diseases. These toxins can be chemicals, viruses, pathogens, or result from internal imbalances. Clear heat and toxin-removing herbs may slow or prevent DNA mutations caused by these toxins. Many herbs in this category have effects similar to antibiotics and some chemotherapeutic agents, such as Adriamycin. These herbs clear heat, inflammation, accumulations, and various toxins, including those causing fevers, inflammations, suppurations, and abscesses. They often treat pain associated with inflammation. While rarely used alone to treat cancers, these herbs, when added to complex herbal formulas, contribute significantly to the antineoplastic effect and enhance the efficacy of cytotoxic conventional therapies. Key herbs in this category include Ku Shen, Shan Dou Gen, Bai Hua She She Cao, Ban Zhi Lian, Pu Gong Ying, Xia Ku Cao, and Jin Yin Hua. These herbs have shown potential in slowing tumor cell growth through various mechanisms. • 4)RUAN JIAN SAN JIE (软坚散结) Ruan Jian San Jie refers to softening and dissolving hard masses. Tumors that are hard in character, feeling like stone, are considered combinations of blood and phlegm stasis tightly intertwined. Herbs that transform phlegm are used along with salty-tasting herbs, which increase the dynamic flow of fluids into a tumor, potentially softening hardness. Many of these herbs also improve immunity and have antineoplastic properties. They are used to treat conditions like lymphadenopathy, goiter, and abdominal masses, and many are sea vegetables such as Kun Bu and Hai Zao. • 5)YI DU GONG DU (以毒攻毒): Yi Du Gong Du refers to the principle of using a poison to combat another poison, specifically cancer. Cytotoxic therapies fall into this category. These herbs are considered toxic from both Chinese and conventional medical perspectives, and are rarely used outside of a formula context. Formulations are based on pharmacological studies targeting specific cancers. In treatment, multiple principles are combined to address cancer within the context of integrating Chinese medicine with conventional treatments. The choice of herbs depends on several factors, including tumor type, the mechanism and side effects of conventional treatments, levels of blood and phlegm stasis, the Chinese medical diagnosis of the cancer, the cancer's stage and aggressiveness, the patient's constitution, and their overall vitality and strength. [Lahans, T. (2007). Integrating conventional and Chinese medicine in cancer care: A clinical guide. Elsevier Health Sciences.]