Written records of the Chinese experience with cancer treatment date back to the time of the Yellow Emperor's Inner Classic (Huang di nei jing), 2nd century BC. This ancient book addresses symptoms similar to those of esophogeal, uterine and bone cancer. 1,800 years ago Dr. Zhang Zhong Jing described treatments for disease processes similar to cancers in his Prescriptions from the Golden Cabinet (Jin Kui Yao Lue), as did Dr. Sun Si Miao in One Thousand Golden Formulas (Qian jin yao fang).
Causes of cancer in TCM are generally divided into internal and external causes. Externals causes were originally related to the general forces called wind, heat, damp, summer heat, dryness and fire. In modern understanding diet, lifestyle, and chemical factors are included in the external causative group.
Internal causes can be divided into four groups:
1. Emotional imbalances, which arise from excess or inappropriate joy, anger, worry (mental stress), anxiety (panic), grief, fear and shock.
2. Accumulation of toxins in the internal organs.
3. Systemic imbalance of Yin and Yang.
4. Deficiency of Qi.
The basic idea is that the external causes cannot cause cancer unless or until the body has weakened from internal causes. The various imbalances, called Qi stagnation, blood stasis, mucus accumulation, dampness stagnation and heat toxins, gradually cause cancer to develop over time. Because the causative factors can be controlled and treated with lifestyle, diet and herbal treatments, this becomes the primary TCM strategy for prevention. It differs from the aforementioned preventive measures only in that TCM-trained doctors are able to identify systemic imbalances within their paradigm and treat them in a more precise way.
Treatment of Chemotherapy and Radiation Side Effects with TCM herbs
Combined treatment has been in continuous development and use in China for the past two decades. The following herbal strategies for combating side effects of radiation and chemotherapy are based upon the collection of data on common usage from physicians in the major hospitals in China, as reported in major journals, articles and books (Huang 1999, Dharmananda, 1998, Long & Mong, 1992, Chang M, 1992). These are general guidelines, and can be modified by qualified doctors, of course. Western practitioners, if they understand the logic underlying the choices below, may substitute herbs with similar actions. For example, milk thistle seed could be used for liver toxicity. Ayurvedic practitioners might use herbs such as guduchi stem and turmeric root. Dosages and relative proportions of herbs should be determined based on signs and symptoms.
• Nausea: Use a combination of pinellia tuber, white atractylodes, licorice root, agastache, tangerine peel and poria mushroom. May be used as a tea or dried decoction.
• Reduction of white blood cells and platelets: Use a formula with astragalus root, polygonatum rhizome (huang jing or P. sibiricum), millettia stem, lycium fruit, tu si zi seed (Cuscuta chinensis ), dang gui root, jujube fruit (da zao or Ziziphus jujuba), tortoise shell (gui ban), ligustrum berry (nu shen zi or L. lucidum), poria mushroom, and deer antler.
• Liver toxicity: Use a formula with capillaris (yin chen hao or Artemisia capillaris), rhubarb root, gardenia fruit (zhi zi or G. jasminoides), salvia root, moutan bark (mu dan pi or Paeonia suffruticosa), dang gui root, curcuma tuber (yu jin or C. longa tuberosa) and schisandra berry. Schisandra berry can be used by itself in large quantity.
• Depression, fatigue, diarrhea, dizziness, poor appetite, insomnia (any two or three of these symptoms): Use the classic formulas gui pi tang or rehmannia six. Some of the major herbs in these formulas are white atractylodes, ginseng root, astragalus root, poria mushroom, honey-fried licorice, dang gui root, cooked rehmannia root, and dioscorea root (shan yao or D. opposita). I advise using relatively small amounts of ginseng or astragalus roots at first, and put more emphasis on honey-fried licorice and dioscorea root, then adjust accordingly.
• Cough, cough with blood, shortness of breath (especially after lung, diaphragm or esophogeal cancer): Use a formula of glehnia root (sha shen or Adenophora tetraphylla), scrophularia root (xuan shen or S. ningpoensis), licorice root, apricot seed, ophiopogon root (mai men dong), rubia root (qian cao gen or R. cordifolia), and cordyceps mushroom.
• Local skin damage from radiation: Externally, use Golden Satisfaction Cream (ru i huang jin san). In a cream base combine rhubarb root, phellodendron bark, cucuma tuber (yu jin or C. longa ), angelica root (bai zhi or A. archangelica), arisaema rhizome (tian nan xing or A. amurense), tangerine peel, black atractylodes, magnolia bark, licorice root and trichosanthes root. Also effective is an ointment containing 4% curcuma tuber (e zhu). Internally, use a formula made of forsythia fruit, honeysuckle flower, moutan bark, salvia root, red peony root, myrrh gum, mastic gum (ru xiang or Boswellia carterii), astragalus root, millettia and dried earthworm (di long or Pheretima aspergillum).
• Bloating, gas, abdominal and stomach pain and bleeding ulcer: Use white peony root, licorice root, dioscorea root, chih-ke, white atractylodes, poria mushroom, hawthorn fruit (shan zha), wheat sprouts (fu xiao mai) and germinated rice sprout (gu ya).
• Kidney toxicity with urging and frequency: Use rehmannia six formula. If there is blood in the urine and severe pain, add poria mushroom, grifola mushroom (zhu ling or Polyporus umbellatus / Grifola umbellata), plantago seed (che quian zi), imperata rhizome (bai mao gen or I. cylindrica), rubia root, agrimony (xian he cao or A. pilosa), di yu root (Sanguisorbia officinalis), and tien chi root.
• Intestinal inflammation and diarrhea or constipation, blood in the stool and pain: Use rubia root, tien chi root, di yu root, sophora flower (Huai hua mi or S. japonica), agrimony, and purslane (ma chi xian or Portulaca oleracea).
• Neuropathy: Use a formula made of drynaria rhizome (gu sui bu or D. fortunei), raw rehmannia root, epimedium, morinda root (ba ji tian or M. officinalis), loranthes (sang ji sheng), salvia root, dang gui root, millettia stem, psoralea seed (bu gu zhi or P. corylifolia), curculigo rhizome (xian mao or C. orchioides), and cibotium rhizome (gu ji or C. barometz). Additional herbs are added depending on the location of the symptoms. For the face: add angelica root and cnidium rhizome (chuan xiong or Ligusticum wallichii). For the upper limbs: add mulberry twig (sang zhi or Morus alba) and cuccuma tuber. For the lower limbs: add achyranthes root (huan niu xi or A. bidentata) and mu gua fruit (Chaenomelis lagenaria )
• Heart damage with edema, breathing difficulty,heart pain shortness of breath, palpitations and angina: Use codonopsis root (dang shen or C. pilosula), glehnia root, ginseng root, salvia root, sophora flower, schisandra berry, ophiopogon root, kudzu root, and cnidium rhizome.
• Hormone imbalances or endocrine disturbances, with reduced or absent menstruation or reduction in sperm count: Use ligustrum fruit (nu shen zi or L. lucidum), eclipta, cinnamon bark, purified aconite (fu zi or Aconitum palmatum), epimedium, dang gui root, cnidium rhizome, salvia root, water plantain (ze xie or Alisma plantago-aquatica ), leonorus (yi mu cao or L. heterophyllus), persica seed (tao ren or Prunus persica), and carthamus flower.
• Hair loss: Use a formula of cooked and raw rehmannia root, ligustrum fruit, dang gui root, donkey skin gelatin (e jiao), deer antler, turtle shell, shou wu root, epimedium and salvia root.
• Local skin discoloration from radiation: Use a formula of salvia root, dang gui root, cnidium rhizome, red peony root, carthamus flower, morinda root (ba ji tian or M. officinalis), cinnamon bark, deer antler, epimedium, tu si zi seed, and lycium fruit.
• Recovery from surgery: Use tien chi root by itself, 2-4 grams twice a day, or make a formula with astragalus root, ginseng root, red peony root, dang gui root, poria mushroom, American ginseng root, tien chi root and wild asparagus root.
Using Herbs to Strengthen the Effects of Chemotherapy
Many Chinese researchers have been focusing on simultaneously stopping the side effects and strengthening the anti-cancer effects of chemotherapy and radiation therapy. We can understand how this is possible if we correlate the general or systemic effects that herbs have (as understood in the traditional sense) with our previous discussion listing the very specific effects many herbs have on immune system parameters. There are least four theoretical groupings:
1. With chemotherapy or radiation patients with signs of severe inflammation and toxins, use herbs with anti-cancer effects that also reduce heat. Examples are subprostrata root (shan dou gen or Sophora subprostrata), scute root, oldenlandia herb (bai hua she she cao or O. diffusa) and prunella (xie ku cao or P. vulgaris) (Huang, 1999, Dharmananda, 1997).
2. With signs of Yin deficiency, use herbs with anti-cancer effects that also nourish the Yin. Examples are raw rehmannia root and scrophularia root (Huang, 1999,
3. With blood congestion or hyper-viscosity, use herbs with anti-cancer effects that also move the blood. Examples are salvia root, cnidium rhizome, tien chi root, millettia stem, and pinellia tuber (Huang, 1999, Dharmananda, 1997).
4.With signs of Qi deficiency and weakness, use herbs with anti-cancer effects that also tonify the Qi. Examples are Siberian ginseng root bark, white atractylodes, ginseng root, and licorice root (Dharmananda, 1997).
It is important to understand that these individual herbs vary in their effects on specific types of cancers, so, although choices can be made based upon energetic considerations, it is wise to check Medline for the latest research findings.
• Japanese researchers noted that enhancing production of tumor necrosis factor (TNF) can benefit cancer patients. In animal models, subprostrata root and white atractylodes were among the crude herbs able to do this without side effects (Xu QA et al., 1989).
• Oldenlandia herb inhibits Yoshida's sarcoma and Ehrlich's ascites sarcoma in vitro. It also inhibits sarcoma-180, ascitic lymphocarcoma and uterine cancer in mice. Scute root strongly inhibits JTC-26, and inhibits sarcoma-37, Ehrlich's ascites sarcoma and cerbroma-B22 in rats (reported in Dharmananda, 1997).