Article
Traditional Chinese Medicine as Supportive Care in Cancer Treatment
Traditional Chinese Medicine (TCM), a treatment method that has been used for centuries to treat cancer, is useful at all stages of the disease. It can be used to reduce the side effects of conventional treatments, to prevent recurrence, and to improve quality of life. TCM includes the modalities of acupuncture, herbal medicine, and Qigong (exercises for internal energy).
In Traditional Chinese Medicine, practitioners attempt to restore health by regulating the balance and flow of energy in the body. Symptoms are thought of as an imbalance of energy as opposed to any specific disease.
ACUPUNCTURE
According to the National Cancer Institute's (NCI) website, acupuncture has shown to be effective for improving immune function, decreasing cancer related pain, treating nausea and vomiting associated with chemotherapy, and reducing tamoxifen induced menopausal symptoms. Acupuncture may also lessen the side effects of conventional treatment (poor appetite, dizziness and fatigue).1
An article directed at oncologists that reviewed the literature on acupuncture in the journal Integrative Cancer Therapies suggests its use for patients with difficult-to-control chemotherapy induced side effects such as pain, fatigue, nausea and vomiting, xerostomia (dry mouth following radiation therapy to the head and mouth), and mood disorders. There may be additional benefits to patients in terms of quality of life, hot flashes, peripheral neuropathy, anorexia, constipation, neutropenia, and spiritual connection, but these have not been well documented the the literature.2
A study of patients treated with acupuncture in an oncology clinic in San Diego revealed acupuncture to be safe, inexpensive and considered to be an important service by their patients. The authors of this study found it to be a useful adjunct in chemo-therapy induced emesis and as an adjunct mechanism of pain control.3
QIGONG THERAPY
Qigong (literally energy cultivation) involves gentle movement techniques aimed at controlling the breath, calming the mind, and treating disease. A review of more than 50 studies of qigong therapy for cancer in China showed that the qigong groups showed more improvement or had better survival rate that conventional methods alone (there were no double blind clinical trials among patient studies but many had a control). There is much room for improvement in these studies, however this is an area that is often neglected and this review suggests that qigong deserves further study as a supplement to conventional cancer treatment.4
Qigong may improve the patient's ability to deal with the cancer and the difficult side effects of treatment. Raven Stevens, a former client (diagnosed with breast cancer in 2001, stage 3B) and current facilitator here at WomenCARE, has this to say about Qigong: "I felt significantly better after each treatment. I don't know how I would have made it through all the chemo and radiation without it. Doing the Qigong exercises/prescriptions over these past 5 years has shifted my energy patterns. As the TCM folks might say...'to pluck the flower is not enough. There is a high likelihood that it will grow right back if you don't change the energetic patterns.' "
Qigong can be done by a trained practitioner and the patient can learn various self healing techniques to be done by themselves at home. When one is very sick it is great to have qigong done on you, as one is usually too weak to focus or shift their energy at this point.
HERBAL THERAPY
Recently there has been a trend to integrate TCM with standard Western medicine in an attempt to relieve the debilitating side effects of chemotherapy and radiation. This form of herbal treatment, known as Fu-Zheng therapy, is used in Chinese hospitals as an adjunct to surgery, radiation and chemotherapy. In more progressive U.S. hospitals, such as Mount Zion Hospital/UCSF Cancer Center and Cedars-Sinai Medical Center, it is being used in the same way. Fu Zheng therapy attempts to strengthen the patient's immune system. It can allow the patient to tolerate higher doses at closer intervals with fewer side effects. It can also give the patient the needed strength to complete the treatment.
Common herbs used in Fu Zheng therapy include Astragalus and Ganoderma lucidum(Reishi). Astragalus has been shown to have immune enhancing benefits. A meta-analysis (a statistical analysis of group studies) of 34 randomized trials representing 2,815 patients concluded that Astragalus-based Chinese herbal therapy may increase the effectiveness of platinum-based chemotherapy for advanced non-small-cell lung cancer when combined with chemotherapy.5
Several studies have shown Ganoderma lucidum to have immune enhancing effects.6,7 A study involving 36 cancer patients with advanced lung cancer showed that some patients demonstrated markedly modulated immune functions after taking Ganoderma lucidum for 12 weeks. The results suggest that some cancer patients may be responsive to Ganoderma lucidum in combination with radiation and chemotherapy.7
Ganoderma lucidum has also demonstrated anticancer activity by suppressing cell adhesion and cell migration (inhibiting tumor growth and metastasis) of highly invasive breast and prostate cancer cells in vitro (a study performed in a test tube or outside of a living organism).8
Curcumin, the yellow pigment in tumeric (Curcuma longa) has been shown to act as a chemopreventive agent because of its anti-tumor, anti-oxidant and anti-proliferative effects. There are in vitro studies showing that curcumin induces apoptosis (cell death) in breast and ovarian cancer cells.9-11
PSK (or Krestin), a mushroom ingredient of Yun Zhi (Trametes versicolor) has been used as an anti-cancer and immune enhancing agent in the treatment of cancers in Asia for over 30 years (it is employed clinically as an anticancer drug in Japan).12 A meta-analysis study that included 1, 094 patients enrolled in three clinical trials suggest that adjuvant immunochemotherapy with PSK can improve both survival and disease-free survival of patients with curatively resected colorectal cancer.13 Yun Zhi has been shownd to exert anti-tumor effects on various types of cancer cells. An in vitro study done on 4 breast tumor cell lines demonstrated that Yun Zhi suppressed the proliferation of three breast tumor cell lines and did not significantly effect the fourth.14
Discomfort and fatigue are common issues for women with breast cancer following conventional therapies. A clinical trial in China evaluated the immunomodulatory effects of Yunzhi-Danshen (two Chinese herbs), in post treatment breast cancer patients. Eighty-two patients took the above herbs in capsule form every day for a total of 6 months. The results showed an increase in immune status markers (an increase in lymphocytes and T cells). The study suggests that Yunzhi-Danshen capsules could be beneficial for promoting immunological function in post treatment of breast cancer patients.15
A recently published textbook, Management of Cancer with Chinese Medicine, by Li Peiwen, 2003, sites numerous randomized controlled studies (the typical study having between 50 and 150 patients) that demonstrate that the combined approach shows significant improvement in the efficacy of the Western treatment. The author of this book was trained in both Eastern and Western medicine and is the Chief Doctor and Director of the TCM Oncology department at the Sino-Japanese Hospital, Beijing since 1984. This book provides a rare insight into the type of studies being carried out in China today in relation to cancer and the role of Chinese medicine in its treatment.
When discussing the anticancer effect of certain herbs (herbs that may inhibit the growth of cancer cells) it is important to note that anti-cancer herbs are not to be thought of as a cure. These herbs are adjunctive and are not meant to replace Western Therapies.
Chinese herbs are rarely prescribed individually. Formulas typically contain from 4 to 18 herbs and can be taken in a variety of ways, including decoctions (herbs boiled in water), pills, capsules and powders. There are several effective remedies that are readily available and very manageable. Current herb quality ranges from very high to very low. Treating cancer with herbs is not like treating a cold with herbs. Don't go it alone. Find a practitioner of Chinese medicine who you trust and who is willing to work with other members of your healing team.
Cancer, being a multifaceted disease, is most effectively managed using more than one form of treatment. There is compelling evidence to suggest that one approach worth considering is Traditional Chinese Medicine.
Emmy Cushnir is a Licensed Acupuncturist and Registered Nurse practicing in Santa Cruz. She has a passion for working with people with cancer. She currently facilitates the Complementary Treatment Group at WomenCARE.
References:
1.www.cancer.gov/cancertopics/pdq/cam/acupuncture/HealthProfessional/page5#Section_64
2. Cohen AJ, Menter A, Hale L. Acupuncture: role in comprehensive cancer care-a primer for the oncologist and review of the literature. Integrative Cancer Therapies 2005; 4(2):131-43 (ISSN: 1534-7354)
3. Johnstone Peter AS, Polston Gregory R, Niemtzow Richard C, Martin Peter J. Integration of acupuncture into the oncology clinic Palliative Medicine 2002:16
4. Chen K, Yeung R. Exploratory studies of Qigong therapy for cancer in China. Integrative Cancer Therapies. 2002; 1(4):345-70 (ISSN:15234-7354)
5. McCulloch M; See C; Shu XJ; Broffman M: Kramer A; Fan WY; Gao J; Lieb W; Shieh K; Colford JM. Astragalus-based Chinese herbs and platinum-based chemotherapy for advanced non-small-cell lung cancer: metanalysis of randomized trials. J Clin Oncol.
6. Chan WK, Lam DT, Law HK, Wong WT, Leung Koo Mw, Lau AS, Lau YL, Chan GC. J Altern Complement Med. 2005; 11(6):1047-57 (ISSN:1075-5535
7. Gao Y, Tang W, Dai X, Gao H, Chen G, Ye J, Chan E, Koh HL, Li X, Zhou S. Effects of water-soluable Gnoderma lucidum polysaccharides on the immumne functions of patients with advanced lung cancer. J Med Food 2005 Summer;8(2):159-68
8. Daniel Silva, PhD., Integrative Cancer Therapies 2003 Vol. 2, No. 4, 358-364
9. Karunagaran D; Rashmi r; Kumar TR. Induction of apoptosis by curcumin and its implications for cancer therapy, Curr Cancer Drug Targets. 2005;5(2):117-29 (iSSN: 1568-0096)
10.Zheng L; Tong Q; Wu C. Growth-inhibatory effects of curcumin on ovary cancer cells an its mechanisms. J Huazhong Univ Sci Technolog Med Sci. 2004; 24(1):55-8 (ISSN: 1672-0733)
11. Ramachandran C, Rodriguez S, Ramachandran R, Raveendran Nair PK, Fonseca H, Khatib Z, Escalon E, Melnick SJ. Expression profiles of apoptotic genes induced by curcumin in human breast cancer and mammary epitheliall cell lines. Anticancer Res. 2005 Sep-Oct;25(5):3293-302
12. Reigetsu Yoshikawa, Hidenori Yanagi, Tomoko Hashimoto-Tamaok, et al. Gene expression in response to anti-tumor intervention by polysaccharide-K (PSK) in colorectal carcinoma cells. Oncology Reports 12: 2004 1287-1293
13. Sakamoto J, Morita S, Oba K, Matsui T, Kobayashi M, Ohashi Y. Efficacy of adjuvant Immunochemotherapy with polysaccaride K for patients with curatively resected colorectal cancer: a meta-analysis of centrally randomized controlled clinical trials. Cancer Immunol Immunother. 2006: 55(4):404-11 (ISSN: 0340-7004)
14. Ho Cy, Kim CF, Leung KN, Fung KP, Tse, TF, Chan, H, Lau CB. Differential Anti-Tumor Activity of Coriolus versicolor (Yunzhi) Extract through P53- and/or Bcl-2-Dependent Apoptotic Pathway in Human Breast Cancer Cells. Cancer Biol Ther. 2005; 4(6):638-44 (ISSN: 1538-4047)
15. Wong Ck, Bao YX, Wong EL, Leung PC, Fung KP, Lam CW. Immunomodulatory activities of Yunzhi and danshen in post-treatment breast cancer patients. Am J Chin Med. 2005; 33(3):381-95 (ISSN: 0192-415X)