Cancer
As elsewhere, cancer is one
of the leading causes of death in China. It is characterized by the uncontrollable
growth of cells originating from abnormal tissues which can kill the host by means
of local extension or distant spread (metastasis). The etiology of cancer is not
completely clear, but the fundamental mechanisms governing the etiology of human
cancer have recently become clearer as new information about cancer genes, viruses,
carcinogens, cell growth and differentiation emerges.
Over the past three
decades, Chinese researchers have studied the role of traditional Chinese medicine
in treating cancer. They have obtained significant results.
Etiology
and Pathogenesis
1. Insufficient vital essence
Insufficient vital essence
causes deficiency syndromes. Since various deficiency syndromes may occur in cancer
patients, insufficient vital essence is considered the basic pathogenesis of cancers.
Insufficient vital essence results from congenital defects, senility, protracted
illness, overexertion, improper diet, over indulgence in sexual activity or invasion
by exogenous pathogenic factors.
2. Blood stasis and phlegm accumulation
Traditional
Chinese medicine holds that cancerous tumors are the result of blood stasis or
phlegm accumulation or both. Qi activates and governs blood circulation. Deficiency
of qi may cause blood stasis. Stagnation of qi, which is usually due to an emotional
upset or affection by exopathogens, is another common factor that impedes the
normal flow of blood and results in blood stasis and eventually tumor formation.
Accumulation of phlegm is related to the various deficiency sates described above,
particularly deficiency of spleen qi characterized by failure in transporting
and transforming the refined substances from food and water which leads to the
formation of phlegm.
3. Invasion of exogenous pathogenic factors
Exogenous
pathogenic heat or cold can invade the body, disturb the smooth flow of qi and
blood and, as a result, cause the retention of qi and blood and the formation
of tumors.
Differential Diagnosis of Syndromes
1. Qi deficiency
Primary
manifestations: general lassitude, shortness of breath, weak breathing and speaking,
spontaneous sweating that worsens on exertion, pale tongue with thin, white coating
and weak pulse.
Conditions associate with cough and expectation of copious
thin sputum indicate a deficiency of lung qi; poor appetite, fullness in the abdomen
after meals, loose stool or edema indicate a deficiency of spleen qi; palpitations
or arrhythmia may appear in cases with deficiency of heart qi.
2. Yang deficiency
Primary manifestations: intolerance of cold, cold limbs, slow pulse with the
manifestations of qi deficiency.
Deficiency of kidney yang is manifested as
weakness of the loins and knees, impotence, frequent urination at night, incontinence
of urine, diarrhea before dawn or edema complicated by the general manifestations
of yang deficiency.
3. Blood deficiency
Primary manifestations: Pallor
or sallow complexion, pale tongue with thin, white coating and thready pulse.
Additional manifestations may include palpitations, insomnia, amnesia and dream-disturbed
sleep, suggesting deficiency of heart blood; blurred vision, dizziness, ringing
in the ears, numbness of the hands and feet or scanty menstrual flow, indicate
deficiency of liver blood.
4. Yin deficiency
Primary manifestations: Dry
mouth with preference for beverages, absence of tongue coating, constipation and
concentrated urine, indicating consumption of body fluids; feverish sensation
in the palms, sole, and chest, afternoon fever, night sweating, deep red tongue
without coating and fine rapid pulse, suggesting interior heat due to yin deficiency.
Patients with yin deficiency, suffering from restlessness, dizziness, dryness
of the eyes, nocturnal emissions, soreness and weakness of the loins and knees,
can be diagnosed as having yin deficiency of the liver and kidneys. Those with
yin deficiency, suffering from dry cough or cough with expectation of scanty,
sticky sputum, can be diagnosed as having yin deficiency of the lungs.
5.
Stagnation of liver qi
Primary manifestations: Fullness and distending pain
in the hypochondriac regions, irritability, belching, loss of appetite, distending
sensations in the breast, thin, white tongue coating and taut pulse.
6. Blood
stasis
Primary manifestations: Fixed pain or mass in a given region of the
body, petechiae or bleeding, dark complexion, dry scaly skin, dysmenorrhea with
discharge of dark-red blood or clots, purple or dark-red tongue and fine and hesitant
pulse.
7. Phlegm-dampness
Primary manifestations: Cough, expectations
of mucoid white sputum, loss of appetite, abdominal distension, white, greasy
tongue coating and slippery pulse.
Treatment
1. Qi deficiency
Principle
of treatment: Invigorate qi.
Formula of choice: Four Gentlemen Decoction;
the most commonly used herbs to tonify qi: Ginseng, codonopsis root, and astragalus
root. For deficiency of lung qi, use Lung-Tonifying Decoction, in which ginseng,
astragalus root, replenish lung qi, tangerine peel and aster root descend lung
qi and prepared rehmannia root and schisandra berry invigorate the kidneys, the
root of qi.
For deficiency of spleen qi, Ginseng, Poria, Ovate Atractylodes
Powder is an effective formula. It includes the ingredients of the decoction of
Four Gentleman Decoction, as well as lablab bean, dioscorea root, coix seed, and
lotus seed which invigorate spleen qi; amomum fruit which enlivens the spleen
and strengthens the action of principal drugs; and platycodon root which acts
as guiding drug. For the cases with deficiency of heart qi, use Heart-Nourishing
Decoction, in which ginseng, astragalus root, licorice root, and schisandra berry
replenish heart qi; cinnamom bark invigorates heart yang; tangkuei and ligusticum
root nourish the heart blood; and jujube, poria, polygala root and biota seed
ease the mind.
2. Yang deficiency
Principle of treatment: Replenish yang
with herbs warm in nature.
Formula of choice: Aconite Center-Rectifying Decoction
for deficiency of spleen yang; in this formula, prepared lateral root of aconite
and blast-fried ginger, both of which are pungent in flavor and hot in property,
restore yang of the spleen and stomach by warming the middle-warmer to dispel
cold; add ginseng, ovate atractylodes root and licorice root to replenish qi and
strength the spleen.
Right-Restoring is an effective recipe for treating deficiency
of kidney yang.
3. Blood deficiency
Principle of treatment: Nourish blood.
Formula of choice: Four Ingredients Decoction to replenish liver blood; the
treatment of blood deficiency is usually combined with herbs that invigorate qi
and nourish the kidneys, for example, Tangkuei Blood-Supplementing Decoction,
which includes a large dosage of astragalus root; Spleen-Returning Decoction is
frequently prescribed for deficiency of heart blood.
4. Yin deficiency
Principle
of treatment: Nourish yin and increase body fluids.
Formula of choice: Since
yin deficiency frequently causes heat, methods for nourishing yin are often used
with those for expelling heat; use Major Origin-Supplementing Decoction to treat
yin deficiency of the liver and kidneys, in which ginseng, dioscorea root and
licorice root replenish the spleen, prepared rehmannia root and tangkuei nourish
liver yin and cornus fruit and lycium berry invigorate kidney yin.
Deficiency
of lung yin can be treated with Lily Bulb Metal-Securing Decoction, in which rehmannia
root nourishes yin and clears away heat from the blood; ophiopogon root, scrophularia
root and lily bulb nourish yin, ,moisten the lungs, remove phlegm and arrest cough;
tangkuei and white peony root invigorate blood and nourish yin; and licorice root
and platycodon root eliminate phlegm and coordinate the effects of the other ingredients
in the formula.
5. Stagnation of liver qi
Principle of treatment: Regulate
liver qi.
Formula of choice: Bupleurum Liver-Soothing Powder.
6. Blood
stasis
Principle of treatment: Promote blood circulation to remove blood stasis.
Formula of choice: Infradiaphragmatic Stasis-Expelling Decoction, in which
tangkuei, ligusticum root, peony root, peach kernel, carthamus flower, flying
squirrel's droppings, moutan bark promote blood circulation to remove blood stasis,
and cyperus root, bitter orange, lindera root and corydalis tuber regulate qi
to alleviate pain.
7. Phlegm-dampness
Principle of treatment: Remove dampness
and phlegm.
Formula of choice: Stomach-Calming Powder and Six Gentlemen Decoction;
in these recipes, ginseng, ovate atractylodes root, poria, and licorice root invigorate
qi, strengthen the spleen and eliminate dampness; atractylodes root and pinellia
root are added to remove dampness, magnolia bark and tangerine peel regulate qi
and dispel wetness and ginger and jujube to regulate the function of the stomach.
By
Dr. Ming's TCM Medical Center,
Hua Xi Xiao Yuan, Hutian Developing
Area,
Huaihua city, Hunan province
China