Cancer is a word which strikes fear into the hearts of many of us. It is often difficult to even utter the word and so we use euphemisms such as 'shadow on the lung', 'tumour', 'swelling' and the like. Consequently, people diagnosed with cancer, and health-care professionals alike, can find themselves swept away by emotion. It is frequently difficult to decide the most appropriate treatment in such an environment. It has been said that we only think about death when we are dying. This is a little late. It is also true that we frequently only think about our health when we are sick. Clearly, if we are prepared, we can deal better with changing circumstances. As practitioners, we have an important role in guiding people towards healthy options, even in the midst of a crisis such as a cancer diagnosis. However, crisis and opportunity are closely connected so the possibility exists of a positive outcome from such a diagnosis.
What can we offer as practitioners of Chinese medicine? This is dependent upon our expertise as practitioners but also on the person who seeks help. For example, some people merely request alleviation of symptoms caused by conventional medical treatment. Other people involve themselves much more in their Chinese medical treatment, look at their diets and take up internal exercises such as tai chi or qi gong. Some completely eschew conventional treatment and seek only support and treatment from holistic medicine, either Chinese medicine or a combination of different therapies. I have observed, over the past 20 years or so in practice, that increasing numbers of people are actively questioning their treatment options and are moving towards holistic methods, either in conjunction with conventional treatment or alone.
The causes of cancer are many and varied yet Chinese medicine agrees with the ancients of Western thought and with traditional doctors in the West that emotional disturbance is the main cause. In addition, environmental influences such as climate, chemical and environmental pollution, irregular lifestyle, dietary habits, mechanical injury particularly if recurrent and inappropriate sexual activity are seen as factors which may lead to cancer.
Whilst radiation and chemicals are seen in the West as being the cause of some cancers, these are very much underplayed. There are political and financial reasons why this may be so, not least the fact that the very chemical companies implicated in environmental pollution are frequently the same ones which produce chemotherapy agents to treat cancer. Recently, it was revealed that Sir Richard Doll, the scientist who made the connection between smoking and cancer, was a paid consultant to several chemical companies including Monsanto. He was paid $1,500 per day in consultancy fees and at the same time wrote that there was no connection between Agent Orange (manufactured by Monsanto) used by the American military in Vietnam and cancer.
As always with Chinese medicine, the diagnosis is the key. Cancer is merely a generic term for a lump (usually) with the capability to invade neighbouring tissues. What is the Chinese medical view of such a condition? Mention of tumours – liu – dates back to the Shang Dynasty (16th-11th century B.C.) and there has been discussion since then of the causation and treatment of cancer by Chinese medicine. A stagnation of Qi leading to stasis of Blood commonly pre-dates a diagnosis of cancer in addition to disturbed ZangFu function. In cases where there are problems with Spleen Qi and fluid metabolism, Phlegm can accumulate and lead to lumps.
So, what to do? The creation of a healthy environment for people – physical and psychological - is important, appropriate work with adequate rest, exercises such as qi gong or tai chi are of inestimable benefit, preventing harmful emotions such as worry, fear, anger, irritation and anxiety and dietary changes. Psychological support is greatly needed to deal with fear and fright, both of which are commonly seen in the West these days but particularly after a diagnosis of cancer. I often feel that it is the fear which kills people as much as the disease itself. Fear, of course, can lead us to all sorts of reactions – not all of which are therapeutic.
For practitioners therefore, we need to take the case, make an accurate diagnosis in terms of traditional Chinese medicine, formulate treatment principles and initiate treatment. Acupuncture and Chinese herbs, together, is the preferred option in my opinion. Qi Gong, tai chi, meditation and visualisation are also of great benefit. Dietary changes are paramount.
There are many methods of treating cancer according to holistic medicine and they all involve a healthy diet, positive attitude and treatment with herbs or similar. Centres such as found in Mexico using Hoxsey methods, the Gerson clinic, and so forth all offer exceptional guidance and support to people with cancer. They are all in Mexico after the Food and Drug Administration in the US drove them out. In the immediate post-war period, the Hoxsey clinics were the largest and most frequent private cancer clinics in the US. Their methods and history are well described in the book, When Healing Becomes a Crime by Kenneth Ausubel (Healing Arts Press, 2000).
An added complication in these modern times is that we frequently treat people diagnosed with cancer who are receiving chemotherapy and/or radiotherapy. Chemotherapy is frequently and aggressively applied to many people and is seen as a necessary treatment by both conventional practitioners and patients. There was little media attention recently to a study that appeared in Clincal Oncology (Morgan, Ward and Barton 2004). This stated that any benefits of chemotherapy are seen in around 2.5% of patients. If I was practising a form of medicine which only benefited 2.5% of people (particularly given the powerful negative effects seen with chemotherapy), I would retrain as a postman or in a career with more opportunity to benefit others.
The energetic effects of chemotherapy drugs were well described by Giovanni Maciocia some years ago in a Three Treasures newsletter when he discussed the use of his Chemosupport herbal formula. Essentially, they have a lot in common with an old herbal treatment for cancer known as escharotics. This is a burning treatment aimed at the tumour itself. The Hoxsey clinics use such herbs in selected cases and I have used them on individual skin tumours. However, with chemotherapy it is applied internally by an intravenous route. Therefore, the burning effect is experienced in the internal organs. In terms of Chinese medicine, you see Rebellious Stomach Qi, Spleen Qi Deficiency, Blood and Yin Deficiency, Heat in the Blood or other organs. Therefore, we need to modify our treatment principles to take account of such drug effects. In addition, the chemotherapy drugs may affect different areas of the body and as a consequence we may need to target our treatment accordingly. The two cases below illustrate this point.
Elizabeth is 52 years old and was diagnosed with breast cancer 2 years ago. She had a mastectomy followed by chemotherapy and radiotherapy. Last year, she developed a lump around the scar and was found to have secondary deposits in the liver and ribs. She was restarted on a course of chemotherapy. Her difficulties with this treatment developed in the gastrointestinal area. She developed a sore mouth, unpleasant taste in the mouth, generally feeling quite unwell with nausea and poor appetite. Her Liver pulse was empty and weak, Spleen pulse tense. Tongue was reddish with small central cracks. I made a diagnosis of Spleen Qi Deficiency, Heat in Stomach and Liver Blood Deficiency. I treated her with acupuncture: Zusanli (ST 36), Ququan (LV 8), Jiexi (ST 41), Liangmen (ST 21), Zhongwan (RN 12). Her herbal formula was:
Dang Shen (Radix Codonopsis Pilosulae) 12g
Fu Ling (Sclerotium Poriae Cocos) 9g
Gan Cao (Radix Glyxyrrhizae Uralensis) 3g
Huang Qin (Radix Scutellariae Baicalensis) 6g
Zhi Zi (Fructus Gardeniae Jasminoidis) 5g
Cang Zhu (Rhizoma Atractylodes) 9g
He Shou Wu (Radix Polygoni Multiflori) 9g
Huang Qi (Radix Astragali Membranacius) 12g
Dang Gui (Radix Angelicae Sinensis) 6g
Dan Shen (Radix Salviae Miltiorrhizae) 3g
One teaspoonful of herbal powder once daily before food.
One week later she felt much better. She had a little nausea and tiredness the day of treatment but nothing since. She was much more positive with good energy. Her stomach felt fine and there was no taste in the mouth. Her Spleen pulse was much more relaxed but her pulse on the left was empty and thin generally. Her tongue was pale and slightly dry.
Her treatments continued throughout her course of chemotherapy and she had virtually no adverse effects with her stomach after that. She retained her hair, which is unusual with the particular chemotherapy drugs she was on and her energy was maintained. She is now post-chemotherapy. She remains well and continues other supportive measures such as a regular Qi Gong practice, healthy diet and moderate exercise. She has also taken the opportunity to give up her job and pursue interests that she has always wanted to do but somehow never found the time. She realises that she needs to do things which 'make her heart sing' and this experience has allowed her to do this.
Holly is 59 years old and had a mastectomy some 10 years ago for breast cancer followed by tamoxifen for 5 years. Three years ago she developed a recurrence locally in the skin around the scar and was given radiotherapy and chemotherapy. A year later, she developed cancer in the remaining breast. I saw her when she had just had her second dose of chemotherapy with Taxol. Her main symptoms were vaginal soreness, redness and irritation. There was no discharge and urination helped her symptoms. She would urinate over 6 times each night and have frequency during the day. Her pulse was thready particularly on the left, tongue reddish with little coat and stripping at the root. I diagnosed Yin Deficiency with Empty Heat in the Lower Jiao. I treated her with acupuncture, Taixi (KI 3), Guanyuan (RN 4), Ligou (LV 5) and gave her a herbal formula:
Shu Di Huang (Radix Rehmanniae Glutinosae Conquitae) 24g
Shan Yao (Radix Dioscoreae Oppositae) 12 g
Shan Zhu Yu (Fructus Corni Officinalis) 12 g
Mu Dan Pi (Cortex Moutan Radicis) 9 g
Fu Ling (Sclerotium Poriae Cocos) 9 g
Ze Xie (Rhizoma Alismatis Plantago-aquaticae) 6 g
Rou Gui (Cortex Cinnamomi Cassiae) 5g
Zhi Mu (Rhizoma Anemarrhenae) 6g
Huang Bai (Cortex Phellodendri) 6g
Half a teaspoonful of herbal powder once daily.
This formula and its variants is a particular favourite of mine. The base of the first 6 herbs is Liu Wei Di Huang Tang (Six Ingredients with Rehmannia) often indicated in Kidney Yin Deficiency. With the addition of Rou Gui (Cortex Cinnamomi Cassiae) and Fu Zi (Radix Lateralis Aconiti Carmichaeli Praeparata) this becomes Jin Gui Shen Qi Wan (Kidney Qi Pill from the Golden Cabinet) used for Kidney Yang Deficiency. Removing the Fu Zi (Radix Lateralis Aconiti Carmichaeli Praeparata) means that the formula can be appropriately applied to children and can be modified with herbs which you could not otherwise add to Jin Gui Shen Qi Wan (Kidney Qi Pill from the Golden Cabinet).
After 2 weeks, the redness and soreness had gone, her bladder felt much more comfortable. After another 4 weeks, her nocturia had diminished to 4 times, her frequency during the day was much easier, the soreness was still absent. Her tongue was now merely reddish with no stripping at the root. Her pulse had improved generally but the Kidney pulses were still very weak and thin.
Her treatment is continuing. In such cases, particularly with a long previous history, with the use of drugs such as tamoxifen which are heating and consume Yin (their typical side effects point to Kidney Yin Deficiency), and current symptoms, I generally treat with tonic formulae. It is possible to clear Heat more strongly and this may be appropriate if the symptoms and the person's energy warrant it. Her response is, however, typical of what happens with Chinese medicine. The person feels much stronger with reduced or absent symptoms.
Stephen Gascoigne qualified in medicine in 1976 in Liverpool, UK and worked for 6 years in hospital and general practice. Stephen trained in acupuncture in China and subsequently in Chinese herbal medicine in London with the esteemed Vietnamese practitioner, Tinh Thong Nguyen. Stephen is the author of The Chinese Way to Health (Connections, 2000), an introduction to Chinese medicine and its methods for the general public and two textbooks for students and practitioners of holistic medicine - The Clinical Medicine Guide (Jigme Press, 2001) and The Prescribed Drug Guide (Jigme Press, 2003).
Morgan, G., Ward, R & Barton, M. (2004). ‘The contribution of cytotoxic chemotherapy to 5-year survival in adult malignancies’. Clin Oncol (R Coll Radiol), 16(8): 549-60.
Further reading and resources:
Prevention and Treatment of Carcinoma in Traditional Chinese Medicine by Jia Kun (The Commercial Press, 1985).
Management of Cancer with Chinese medicine by Li Peiwen (Donica Publishing Ltd, 2003)
Getting Well Again by Simonton, Creighton and Matthews (Bantam, 1992)
This outlines approaches through meditation and visualisation that are extremely helpful for people with cancer.
The Holistic Approach to Cancer by Ian B. Pearce (C.W. Daniel, 1995)
This has a common-sense approach to cancer and is eminently suitable for someone first diagnosed with cancer. It is clearly written and full of common sense information.
Love, Medicine and Miracles by Bernie Siegl (Rider, 1999)
Written by a US surgeon, this is full of inspiring stories and appropriate recommendations to maximise our health and help us eradicate serious illness.
Living Proof by Michael Gearin-Tosh (Scribner, 2002)
An inspiring story of an Oxford professor diagnosed with terminal cancer. This is an account of his search for health and vitality. He is alive and well some 8 years later after following a regime that includes dietary treatment and meditation.