Cancer, Acupuncture, and Chinese Medicine

Recently, a client who I treat to minimize the side effects she has experienced from combined chemo and radiation therapy asked me for more information on the use of acupuncture and Chinese medicine for such purposes. This woman has recently become very active in leading support groups for other people who are going through what she has and is trying to improve their lives, so of course I was happy to provide her everything that I could on the topic. However, it got me to thinking that this might be interesting blog material, since I often work with people going through cancer treatment.

In this young woman's case she had undergone a complete hysterectomy and as a consequence was experiencing menopausal symptoms: hot flashes, anxiety, heart palpitations, vaginal dryness and decreased libido. Because her cancer was estrogen dependent she was unable to use hormone replacement therapy and was expected to spend the rest of her life suffering with these symptoms. In addition, she was justifiably concerned that some other form of cancer might develop and wanted to use acupuncture and herbal therapy to minimize the chances of this occurring.

This creates a context for discussing cancer from a Chinese medical perspective: acupuncture and herbology are very useful to mitigate the side effects of modern oncological intervention and to improve the immune system of patients who have had theirs damaged from chemo or radiation therapy. Historically it was also used to treat the cancer itself directly. However, while tumor attacking protocols are still used today, they are very rare. Even in China most patients routinely combine both Western oncological therapy with acupuncture and herbology. This is because many clinical trials in China have established that the best outcomes in cancer patients come from merging the two traditions to offer the patient the strengths of each system in a united front.

Regardless of the cancer that the client has been diagnosed with, we approach each person as an individual. A strength of Chinese medicine is that it works with the sum total of the person. This includes the disease diagnosis as well as all other symptoms that the person may present with. As a simplistic example of what this means, if two people present with a late stage pancreatic cancer but one has a propensity for being cold and the other for being hot, each person would receive a slightly different acupuncture treatment. This gives superior results to a cookie cutter approach wherein every patient receives the same treatment without considering the idiosyncrasies of their body.

Below I list an embarrassment of riches, link-wise. There is so much information on cancer and acupuncture/Chinese medicine that it was quite difficult to limit the list to the following.  Some of them are intended for laypeople, while others are oriented toward the practitioner. The latter will probably be of much more interest to another acupuncturist or to western medical professionals. In addition, listing a few of the studies demonstrates that acupuncture and herbology are not static fields. Rather they are adaptive and continually improving the protocols used to help our clients.

Links and Research: 

 A study done by the Cancer Treatment Centers of America, and which can be read about here, found that acupuncture was extemely useful for treating chemotherapy related neuropathy, noting that:

 . . . all of the patients reported or had improvement in their CIPN grades after starting acupuncture.

The researchers note that using customized acupuncture point prescriptions in the TCM style produces superior patient outcomes when the use of distal acupuncture points are employed. The researchers emphasize the need for customization of the acupoint prescriptions per each patient’s differential diagnostics for maximum clinical efficacy. In addition, they emphasize that distal acupoints “increase blood flow” and therefore have an especially important role in the treatment of CIPN.

• New research supports our use of the Chinese herb coriolus versicolor to prevent cancer recurrence. This herb is frequently added to our tailored formulae and has further evidence to bolster it's inclusion:

A meta-analysis from Hong Kong has provided strong evidence that the fungus Yun Zhi (Coriolus versicolor) can increase survival rates in cancer patients, particularly those suffering from carcinoma of the breast, stomach and colon. Thirteen clinical trials met the authors’ inclusion criteria. The results showed that Yun Zhi confers a significant survival advantage compared with standard conventional anti-cancer treatment alone. Of patients randomised to Yun Zhi, there was a 9% absolute reduction in five-year mortality, resulting in one additional patient alive for every 11 patients treated. In patients with breast cancer, gastric cancer, or colorectal cancer treated with chemotherapy, the effects of the addition of Yun Zhi to the treatment regime on the overall five-year survival rate were evident, however this was not true for oesophageal cancer and nasopharyngeal carcinoma. (Efficacy of Yun Zhi (Coriolus versicolor) on Survival in Cancer Patients: Systematic Review and Meta-Analysis. Recent Pat Inflamm Allergy Drug Discov. 2012 Jan 1;6(1):78-87).

• A recent study evaluated a well known Chinese medical formula that acupuncturists frequently use, called Gui Zhi Fu Ling Wan, and found that it had potent anti-bladder cancer effects:

When tested, researchers discovered that Gui Zhi Fu Ling Wan may be as effective as the chemotherapy drugs mitomycin C, epirubicin and cisplatin. Further, the researchers made an important and unexpected discovery. The herbal formula exhibited significantly greater selectivity towards cancer cells than did the chemotherapy agents. In other words, Gui Zhi Fu Ling Wan is more effective in targeting cancer cells than conventional chemotherapy agents. This highly targeted mechanism of action may point to one of the reasons, combined with its low toxicity, why the herbal formula does not cause harmful side effects. The researchers were able to measure the exact biochemical processes by which the herbal formula exhibited its effects and suggest that Gui Zhi Fu Ling Wan causes genotoxic stresses on highly replicating cancer cells. The highly targeted genotoxic effects of Gui Zhi Fu Ling Wan damage the DNA of aggressive cancers cells thereby eliminating them and preventing them from replicating while leaving healthy cells unharmed. Gui Zhi Fu Ling Wan was discovered to activate CHK2 and P21, important proteins involved in cell cycle arrest, thereby interfering with the cell cycle progression of cancer cells.

• See my post on the recent Wall Street Journal article on cancer and Chinese herbology here.

• One study, investigating the effects of acupuncture on chemotherapy induced pain, found that the therapy reduced pain throughout the body, particularly in lower body neurapathies. The research, which can be read about here, found that,

...both the speed and intensity of nerve signaling improved in five of the six patients who had acupuncture, and the five patients also said that their condition had improved.

Among patients in the comparison group, nerve speed stayed the same in three, improved in one and decreased in one. Nerve intensity improved in two, decreased in two, and stayed the same in one. 

• A British study found that acupuncture can significantly improve fatigue, nausea and hot flash experiences after cancer chemotherapy. The study, which can be read about here, compared three groups of patients: one treated with acupuncture, one with acupressure and the final group only with 'sham' acupuncture' – acupuncture at fake points. The study showed dramatic differences in symptom improvement between the acupuncture groups and the other two.

. . . these studies show, acupuncture can reduce fatigue, anxiety, and even pain caused by chemotherapy cancer treatments. 

• A Yale study, readable here, evaluated hot flash reduction in breast cancer survivors and found that there was,

a 30 percent reduction of hot flashes for women receiving acupuncture. The women received traditional acupuncture points indicated for hot flashes and menopausal symptoms including acupuncture points for sleep disturbances, loss of concentration, pain, headaches, and anxiety. They received a total of eight, 20-30 minute, acupuncture treatments over a period of 12 weeks. 

In most cases, the use of the chemotherapy agent tamoxifen initially caused or intensified hot flashes. Other hormonal agents also caused the hot flashes. The study shows that acupuncture is an appropriate treatment protocol for women receiving chemotherapy for the treatment of breast cancer. The study also measured physical improvements for women receiving acupuncture over the control group, “There was a significant difference in the average physical quality of life scores from Week 1 to Week 11 in the Acupuncture Specific treatment group. This indicates the acupuncture treatment had an impact on physical symptoms separate from hot flashes.”

• The journal, Bioscience Trends has an article reviewing the evidence for herbal medical intervention as a complementary approach to chemo- and radiation therapies. As reported in the article (readable here):

By reducing side effects and complications during chemo- and radio- therapy, Chinese herbal medicines have a significant effect on reducing cancer-related fatigue and pain, improving respiratory tract infections and gastrointestinal side effects, protecting liver function, and ameliorating the symptoms of cachexia. (Chinese herbal medicines as adjuvant treatment during chemo- or radio-therapy for cancer. Biosci Trends. 2010 Dec;4(6):297-307).

• A research study on hot flashes and prostate cancer, readable here, and published in the International Journal of Radiation Oncology•Biology•Physics, found that, " 

Acupuncture provides long-lasting relief to hot flashes, heart palpitations and anxiety due to side effects of the hormone given to counteract testosterone, the hormone that induces prostate cancer

• Here is a nice overview of traditional Chinese medicine's approach to understanding cancer, including the emotional component: www.itmonline.org

• The Institute for Traditional Medicine discusses cancer and emotion from an Acupuncture/Chinese Medicine perspective: itmonline.org.

Breast Cancer Survival and Chinese Medicine 

• A study was conducted by the Cochrane Collaboration, a UK charity, focusing on reviewing health-specific scientific data, and reported here.

Scientists analysed data from seven studies involving 542 women with breast cancer. They concluded that Chinese medicines [herbal formula] may safely reduce the immuno-suppressive side effects of powerful anti-cancer drugs. These side effects include nausea, vomiting, fatigue, inflammation of the gut lining, reduced blood counts, and suppressed immune systems.

Lymphedema and Chinese Medicine

An unpleasant sequela to some breast cancer surgeries can be a painful, and disfiguring condition wherein the arms swell dramatically. This is due to the removal of the lymph nodes. This article discusses the acupuncture and herbal approaches available to deal with this problem. At itmonline.org

• Excerpted from WebMD.com: (see their site for the complete article at: webmd.com

Sept. 22, 2008 -- Acupuncture eases the hot flashes and night sweats common in women taking tamoxifen and Arimidex after breast cancer treatment.

In a clinical trial, acupuncture helped hot flashes as much as Effexor, the antidepressant currently prescribed for women suffering the menopausal side effects of anti-estrogen drugs.

Effexor itself has troubling side effects, but acupuncture doesn't, says study leader Eleanor Walker, MD, a radiation oncologist at Detroit's Henry Ford Hospital.

"With acupuncture you can get a treatment for those hot flashes that can alleviate them equal to drug therapy -- without side effects and with improved quality of life," Walker tells WebMD.

Men, too, can improve their sexual function with acupuncture treatment. Walker says acupuncture can ease the side effects of chemical castration -- androgen-deprivation therapy -- in men treated for prostate cancer.

• Excerpted from Medicine.net (see site for full article at: http://www.medicinenet.com/script/main/art.asp?articlekey=89904 ) 

• Acupuncture Eases Side Effects of Head, Neck Cancer Treatments

By Amanda Gardner

June 1 (HealthDay News) — Two of the more common and unpleasant side effects of treatment for head and neck cancer patients may be relieved by the ancient Chinese practice of acupuncture.

A new study found significant reductions in both dry mouth and pain and shoulder dysfunction after neck dissection in patients receiving acupuncture. 

• Excerpted from BreastCancer.org (see complete article at: breastcancer.org/treatment

"I had such miserable hot flashes from tamoxifen that I couldn't sleep. Finally, a friend suggested acupuncture. I was very skeptical—I couldn't believe these tiny needles would do anything. All I know is that it didn't hurt, and after four or five sessions, my hot flashes weren't gone, but they were certainly not as frequent or severe."
—Inez, breast cancer survivor 

• From an Acupuncture Today article. (For full article see: acupuncturetoday.com

Yet ... as an adjunctive therapy, acupuncture also can help cancer patients endure and recover from the ravages of cancer treatment. Vivien Griffiths, PhD, an acupuncturist and coordinator of postgraduate studies and the master's of health science in acupuncture program at Australia's Southern Cross University, is also a breast cancer survivor. When she was diagnosed two years ago, Vivien said she initially didn't consider acupuncture a primary treatment due to the shock and expediency of her diagnosis. She had the opportunity to undergo surgery and chose to have the tumor removed. Although unsure, she chose chemotherapy,as well. Due to the side-effects of the chemotherapy, she then sought an acupuncturist who was prepared to become involved in her recovery plan.

Following the mastectomy, her own personal acupuncturist used needles coupled with electrical stimulation at the leading edges of her surgical scar. Within 12 hours, the scar changed color from blue to a warm pink, and her pain related to movement greatly lessened. This improvement allowed her to undertake lymphatic drainage therapy and more vigorous physiotherapy.

Dr. Griffiths believes there is enormous potential for using acupuncture for post-cancer patients: first, to enhance the immune system of clients who are immunosuppressed (by chemotherapy and radiation) to assist their own bodies staying in remission; and second, for preventive care.

"As a cancer patient, you receive a cancer diagnosis and a whirlwind of activity begins: constant tests, surgery, chemotherapy, radiation," she said. "But once the cancer is arrested, it's a long struggle to regain the health one had prior to the diagnosis. It seems as if having a strong, healthy immune system is not perceived as 'that important' by conventional medicine. You're sent on your way and told to report back for a check-up once a year. You hold your breath hoping the cancer doesn't return. When you get a good result from your check-up, you think 'Thank God, I've got another year.' Your life depends on those words 'in remission' or 'clear.' Who or what is helping cancer survivors to stay in that category?"

• From ABCnews.com (for complete article see: abcnews.go.com

New research suggests that acupuncture, an ancient Chinese form of healing, is as good or better than modern medicine in helping ease the side effects of breast cancer treatment. Researchers say acupuncture, which has been around for thousands of years, can give cancer patients a wide range of benefits. Dr. Barrie Cassileth, chief of integrative medicine services at Memorial Sloan-Kettering Cancer Center in New York, shares her advice and answers common questions about acupuncture for cancer patients.

• From ScienceDaily.com (for complete article see: sciencedaily.com

ScienceDaily (Apr. 25, 2009) — Twice weekly acupuncture treatments relieve debilitating symptoms of xerostomia - severe dry mouth - among patients treated with radiation for head and neck cancer, researchers from The University of Texas M.D.Anderson Cancer Center report in the current online issue of Head & Neck.

"The quality of life in patients with radiation-induced xerostomia is profoundly impaired," said Chambers, the study's senior author. "Symptoms can include altered taste acuity, dental decay, infections of the tissues of the mouth, and difficulty with speaking, eating and swallowing. Conventional treatments have been less than optimal, providing short-term response at best."

M. Kay Garcia, LAc, Dr.P.H., a clinical nurse specialist and acupuncturist in M.D.Anderson's Integrative Medicine Program and the study's first author, noted that patients with xerostomia may also develop nutritional deficits that can become irreversible. The twice weekly acupuncture treatments produced highly statistically significant improvements in symptoms. Measurement tools included: the Xerostomia Inventory, asking patients to rate the dryness of their mouth and other related symptoms; and the Patient Benefit Questionnaire, inquiring about issues such as mouth and tongue discomfort; difficulties in speaking, eating and sleeping; and use of oral comfort aids. A quality-of-life assessment conducted at weeks five and eight showed significant improvements over quality-of-life scores recorded at the outset of the study.

• From the National Cancer Institute: (for complete article, see: www.cancer.gov

Acupuncture, a complementary and alternative (CAM) therapy used in cancer management, has been used clinically to manage cancer-related symptoms, treat side effects induced by chemotherapy or radiation therapy, boost blood cell count, and enhance lymphocyte and natural killer (NK) cell activity. In cancer treatment, its primary use is symptom management; commonly treated symptoms are cancer pain,[4,5] chemotherapy-induced nausea and vomiting, [6] and other symptoms that affect a patient’s quality of life, including weight loss, anxiety, depression, insomnia, poor appetite, and diarrhea. [7-9] Acupuncture is generally accepted by children aged 10 years and older.[10]

• From Acupuncture Today, citing the Canadian Cancer Society: (for complete article, see: acupuncture.com/

Acupuncture for various stages of cancer
For conditions where the cancer is detected early, acupuncture can maintain and promote the normal functioning of the body.(10) Several studies done primarily on animals have shown its ability to boost the immune system and encourage the growth of healthy functioning cells.(3) This could be important for counteracting the result of radiation and chemotherapy that tend to attack both normal and abnormal cells. An additional benefit of acupuncture is that it can induce a state of deep calm and relaxation and alleviate physical and emotional tensions.

In cases where a tumour has formed, acupuncture can be used pre- and post-operatively where appropriate as an adjuvant therapy to surgery, radiation, or chemotherapy.(10) According to a study done by Poulain (1997) on 250 patients who underwent gynecological surgery for cancer, acupuncture was shown to speed recovery time.(11) A recent study done by Aldridge (2001) on a series of 40 breast cancer patients, found that acupuncture could reduce nausea and vomiting following surgery and significantly reduce post-operative pain.(12)

For advanced stages of cancer, acupuncture can be used in conjunction with other forms of palliative care to significantly reduce the sensation of pain.(10) In some cases, patients may be able to reduce the dosage of pain medication substantially and thereby avoid the harsh side effects that are often associated with them.(11)

• Metastatic Bone Cancer

abstracted & translated by Bob Flaws, Lic. Ac., FNAAOM (USA), FRCHM (UK)

excerpted from BluePoppy.com

Metastatic bone cancer occurs when cancer cells from the original tumor area travel (or metastasize) through the body and move into the bone. Metastatic lesions are common with cancer of the breast, lung, prostate, kidney, and thyroid. One of the main symptoms of bone cancer is bone pain. The treatment of cancer of the bone, especially metastatic cancer, has two goals: 1) management of the neoplasm and 2) management of the symptoms produced by the local lesion. Prognosis is affected by a patient’s age, the size of the primary tumor, grade and stage, degree of lymphatic and blood vessel invasion, the duration of symptoms and the location of the tumor on the arm, leg, or trunk. There are two ways bone metastasis is treated in standard Western medicine. Systemic therapy, aimed at cancer cells that have spread throughout the body, includes chemotherapy, hormone therapy, and immunotherapy. Local therapy, aimed at killing cancer cells in one specific part of the body, includes radiation therapy and surgery. At present, there is no cure for metastatic bone disease.

On pages 16-17 of issue #1, 2005 of the Zhe Jiang Zhong Yi Za Zhi (Zhejiang Journal of Chinese Medicine), Wang Yun-qi, of the Hunan Provincial Tumor Hospital, published an article titled, "Clinical Observations on the Treatment of 30 Cases of Metastatic Bone Cancer with Yang He Tang Jia Wei (Yang-harmonizing Decoction with Added Flavors) Combined with 99m Technetium-Methylene Diphosphate [TC-MDP] Compared to 30 Cases Only Treated with TC-MDP." Since this study suggests that the combination of Chinese herbal medicine in tandem with chemotherapy gets better results than chemotherapy alone in the treatment of metastatic bone cancer, a summary of this study is presented below.

• Acupuncture & Late Stage Digestive Tract Cancer Lack of Appetite (Treated by Acupuncture)

Abstracted & translated by Honora Lee Wolfe, L.Ac., FNAAOM (USA)

Excerpted from BluePoppy.com

On pages 67-68 of issue #4, 2006 of Xin Zhong Yi (New Chinese Medicine), Li Pei-xun and Jia Ying-jie of the First Affiliated Hospital of the Tianjin College of Chinese Medicine published an article titled, "Observations on the Therapeutic Effects of Treating 27 Cases of Late Stage Digestive Tract Cancer Lack of Appetite with Acupuncture." A summary of this study is presented below.

Cohort description:

Altogether, there were 50 cases of late stage digestive tract cancer anorexia enrolled in this two-wing comparison study. These were randomly divided into a treatment group of 27 cases and a comparison group of 23 cases. In the treatment group, there were 17 males and 10 females 45-76 years of age, with an average age of 54.8 years. Six of these cases had large intestine cancer, six had various types of stomach cancer, three had pyloric cancer, two had pancreatic cancer, and 10 had liver cancer, with 15 cases having accompanying cancer in the abdominal lymph nodes, four having multiple metastases to the abdominal cavity, and six cases having recurrences after surgery. In the comparison group, there were 14 males and nine females 43-75 years of age, with an average age of 54.3 years. Five of these had large intestine cancer, four had various types of stomach cancer, two had pyloric cancer, two had bile duct cancer, one had pancreatic cancer, one had esophageal cancer, and eight had liver cancer. Eleven cases had abdominal cavity lymph node involvement, four had intra-abdominal metastases, and five had recurrences after surgery. Therefore, the two groups were judged to be statistically comparable for the purposes of this study.

• A Study on the Integrated Chinese-Western Medical Treatment of Prostate Cancer

excerpted from BluePoppy.com

abstracted & translated by Bob Flaws, L.Ac., FNAAOM (USA), FRCHM (UK)

Study outcomes:

1. Quality of life

The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30) was administered before and after treatment. Marked effect was defined as 20 point of more increase in score after treatment. Some effect was defined as a 10-20 increase in score, and no change was defined as an increase of 0-9 points after treatment. After treatment for 12 months using the above treatment protocol, 115 cases (81.0%) experienced some improvement in their quality of life. In addition, 22.4% had developed hot flashes, 13.8% had developed osteoporosis, and 11.7% had developed breast swelling and pain.

2. Survival rate & PSA relapse (i.e., time to progression [TTP])

These 142 cases were followed up for 1-50 months. During that time, 16 patients died. Therefore, the total survival rate was 88.73%. The overall average survival time was 27.7 months. The overall average time of non-progression of disease was 25.2 months. Among the 21 cases who were T3-4NxM1c, their condition did not progress for an average of 24.3 months. In addition, after castration and a PSA of 0, their PSA relapsed within a median of 23.9 ± 19.2 months, while their PSA increased within a median of 24.1 ± 20.4 months. Among the 110 cases who were T3-4NxM1b, their condition did not progress for an average of 24.3 months. Further, after castration and a PSA of 0, their PSA relapsed within a median of 20.1 ± 15.2 months, while their PSA increased within a median of 22.3 ± 17.4 months.

3. Bone metastases & emission computed tomography (ECT) bone scan

In the 110 patients who were T3-4NxM1b with bone metastases, those metastases disappeared in four cases and shrunk or became paler in 79 cases, in 18 cases, there was no further spread or increase, and in the other nine patients, there were no new metastases seen. Prior to treatment, the mean number of metastases seen with ECT was 7.6 ± 4.7. After 12 months of treatment, it was 3.4 ± 1.7; after 24 months of treatment, it was 2.6 ± 1.4; and after 36 months of treatment, it was 4.8 ± 2.1.

4. Changes in blood analysis from before to after treatment

The following table shows mean numbers of white blood cells (WBCs), hemoglobin (Hb), and blood platelet count (BPC) from before to after treatment.

Blood factor Before tx At 12 months At 24 months At 36 months WBC (x109/L) 6.47 ± 2.35 7.32 ± 2.51 7.46 ± 1.94 7.37 ± 2.15 Hb (g/L) 106 ± 12 120 ± 11 128 ± 14 121 ± 12 BPC (x109/L) 206 ± 14 231 ± 23 227 ± 25 224 ± 16

Based on these outcomes, after treatment for 24 and 36 months, WBCs were markedly higher than before treatment. In addition, at 12, 24, and 36 months of treatment, both Hb and BPC were markedly higher than before treatment.

Discussion:

According to its authors, this study was designed to see if standard Western medical treatment combined with Chinese medical therapy to support the righteous and repress cancer (fu zheng yi ai) can improve the survival rates, quality of life (QL) and time to progression (TTP) of prostate cancer as well as mitigate some of the common side effects of the standard Western medical care for this difficult-to-treat disease. The supplementing or righteous-supporting medicinals in the above formula have an immune-modulating effect and can strengthen and increase lowered physical immunity. Hence, clinically, it was demonstrated that the above protocol did markedly increase WBCs, Hb, and BPC after treatment. On the other hand, Chinese medicinals which disinhibit dampness, dispel stasis, and clears heat and resolve toxins have been shown to either suppress or kill prostate cancer cells. In particular, Bai Hua She She Cao has been shown to promote prostate cancer cell apotosis (death). The authors of this study conclude that the combination of Chinese medicinals to support the righteous and repress cancer with standard Western medical care can increase the survival rate and markedly improve quality of life in patients with prostate cancer.

• Post Breast Cancer Chemotherapy Leukopenia & Acupuncture

excerpted from BluePoppy.com

abstracted & translated by  Bob Flaws, L.Ac., FNAAOM (USA), FRCHM (UK)

On page 46 of issue #1, 2008 of the Zhe Jiang Zhong Yi Za Zhi (Zhejiang Journal of Chinese Medicine), Wu Jian-jun and Cheng Ling-juan published an article titled “The Treatment of 21 Cases of Post Breast Cancer Chemotherapy Leukopenia by Acupuncture-moxibustion at Zu San Li.” Leukopenia is a common term to describe a low white blood cell (WBC) count. A summary of this article is presented below.

Study outcomes:

Outcomes criteria were based on those found in Zhong Yao Xin Yao Lin Chuang Yan Jiu Zhi Dao Yuan Ze (Reference Principles for Chinese Medicinal & New Medicinal Clinical Research). After 1-2 courses of treatment, 19 cases experienced a marked effect. This meant that their WBCs increased to 4.0 X 109/L and remained at that level for at least one week after stopping treatment. In addition, there was a marked reduction in these patients’ clinical signs and symptoms. One other case got some effect. This meant that their WBCs were still slightly less than 4.0 X 109/L. However, they had increased after treatment by 0.5-1.0 X 109/L, this increase had remained stable for one week after cessation of treatment, and their signs and symptoms had improved. The last case got no effect. This meant that their WBCs were still less than 4.0 X 109/L and had only increase by less than 0.5 X 109/L and there was no improvement in their clinical signs and symptoms. Therefore, the total effectiveness rate was 95.24%.

Discussion:

Leukopenia after chemotherapy for breast cancer is a commonly seen complication of that treatment. In Chinese medicine, this condition corresponds to the traditional Chinese disease category of vacuity taxation and is mostly the result of qi and blood dual depletion. Zu San Li. Moxibustion at Zu San Li can prevent disease and improve health as well as strengthen the patient’s immune function. It has the function of supplementing vacuity and boosting the qi. Moxibustion is able to warm and supplement the spleen and kidneys in order to promote the engenderment and transformation of the qi and blood. When patients’ righteous qi is vacuous and weak, this point should be needled lightly with mild hand techniques in order to diffuse and scatter evils but without further damaging the righteous qi. As stated in the Ling Shu (Magic Pivot), “When the vessels are replete, needling deeply drains this qi; when the vessels are vacuous, needling shallowly promotes the essence qi without obtaining its discharge.” When Zu San Li is needled along with other points based on following the patient’s personally presenting signs and symptoms, it treats post-chemotherapy leukopenia relatively well. Therefore, the two Chinese authors of this study think that it should be more widely used by other practitioners.

From the journal Lung Cancer: excerpted from Pubmed:

• Oral Chinese Herbal Medicine (CHM) as an Adjuvant Treatment During Chemotherapy for Non-Small Cell Lung Cancer

Chen S, et al. School of Medicine, University of Southampton, Southampton, UK.

Non-small cell lung cancer (NSCLC) remains a major global health problem because of its prevalence and poor prognosis. Treatment options are limited and there is a need to explore alternatives. This systematic review evaluates the role of Chinese herbal medicine (CHM) in association with chemotherapy for NSCLC. METHODS: English and Chinese databases were searched for RCTs comparing CHM with conventional biomedical treatment or placebo. Papers were reviewed systematically and data were analyzed using standard Cochrane software Revman 5. RESULTS: Fifteen Chinese trials involving 862 participants met the inclusion criteria. All trials were of poor quality with a considerable risk of bias. There was a significant improvement in quality of life (QoL) (increased Karnofsky Performance Status) (RR 1.83, 95% CI 1.41-2.38, p<0.00001 for both stages III, IV only NSCLC and all stages NSCLC) and less anaemia (RR 0.37, 95% CI 0.15-0.91, p=0.03 for stages III, IV only NSCLC; p=0.005 for all stages NSCLC) and neutropenia (RR 0.42, 95% CI 0.22-0.82, p=0.01 for stages III, IV only NSCLC; p<0.00001 for all stages NSCLC) when CHM is combined with chemotherapy compared to chemotherapy alone. There was no significant difference in short term effectiveness and limited inconclusive data concerning long term survival. Five promising herbs have been identified. CONCLUSION: It is possible that oral CHM used in conjunction with chemotherapy may improve QoL in NSCLC. This needs to be examined further with more rigorous methodology.

Lung Cancer. 2009 Dec 14.

• From the journal Agricultural Food Chemistry. Excerpted from PubMed

Anticancer Effects of Flavonoid Derivatives Isolated from Millettia reticulata Benth (Ji Xue Teng) in Hepatocellular Carcinoma Cells. Fang SC, et al. Department of Food Nutrition, Chung Hwa University of Medical Technology, 89 Wenhwa First Street, Tainan 71703, Taiwan.

Millettia reticulata Benth is cultivated in Asian countries. M. reticulata Benth has multiple biological functions and is one of the oldest tonic herbs in traditional Chinese medicine. It has been elevated to one of the most commonly used herbs in modern Chinese medicine. The aims of this work were to study the in vitro anticancer activity of flavonoid derivatives isolated from the stems of M. reticulata Benth. Six flavonoid derivatives including (-)-epicatechin (1), naringenin (2), 5,7,3',5'-tetrahydroxyflavanone (3), formononetin (4), isoliquiritigenin (5), and genistein (6) were isolated from the stems of M. reticulata Benth. The structures of 1-6 were determined by spectroscopic methods. The effects of flavonoid derivatives (1-6) on the viability of human cancer cells (including HepG2, SK-Hep-1, Huh7, PLC5, COLO 205, HT-29, and SW 872 cells) were investigated. The results indicated that genistein (6) had the strongest inhibitory activity with an IC(50) value of 16.23 muM in SK-Hep-1 human hepatocellular carcinoma cells. Treatment of SK-Hep-1 cells with genistein (6) caused loss of mitochondrial membrane potential. Western blot data revealed that genistein (6) stimulated an increase in the protein expression of Fas, FasL, and p53. Additionally, treatment with genistein (6) changed the ratio of expression levels of pro- and anti-apoptotic Bcl-2 family members and subsequently induced the activation of caspase-9 and caspase-3, which was followed by cleavage of poly(ADP-ribose) polymerase (PARP). These results demonstrate that genistein (6) induces apoptosis in SK-Hep-1 cells via both Fas- and mitochondria-mediated pathways.

J Agric Food Chem. 2009 Dec 8.

• Another source on this information, Oncology Nurse Advisor recommends acupuncture to manage symptoms of cancer, including fatigue. This is based on many sources, including a UCLA acupuncture study with cancer patients which found that, 

Fatigue was reduced by 66% among the study participants in the treatment group.

• From the June 2011 edition of the journal, Acupuncture Medicine, comes a study of acupuncture for people in the terminal stages of cancer. The study found that there was a significant reduction in symptoms (pain, nauseau, fatigue) when working in this type of palliative care setting. A synopsis can be read here.

Patients with advanced incurable cancer appear to benefit from incorporating acupuncture in their treatment.

 

• File under reductionist advances: a study from the National Center for Biotechnology Information/National Institutes for Health found that the Chinese herb Yuan Zhi (Coriolus versicolor) offered a very strong immune enhancing property for survivors of cancer. In general, acupuncturists combine Yun Zhi with other ingredients in formulae that are tailored to the specific cancer and constitutional type of the patient. Still, this is yet another supportive piece of data which underscores the use of Chinese medicine for cancer and for preventing recurrences of cancer. The study, which can be read about here, concluded that,

This meta-analysis has provided strong evidence that Yun Zhi would have survival benefit in cancer patients, particularly in carcinoma of breast, gastric and colorectal. Nevertheless, the findings highlight the need for further evidence from prospective studies of outcome to guide future potential modifications of treatment regimes. Recent patents on the use of mushrooms for the treatment of cancer are also summarized in this review.

• Researchers from the University of Machester studied cancer, anxiety, fatigue when treated with acupuncture. (you can read about it here).

[They recruited]302 volunteers diagnosed with breast cancer. Seventy-five of the patients received the standard care, while the remainder received acupuncture in addition to their regular medical treatments. Treatment was delivered by acupuncturists once a week for six weeks. At the end of the study, the patients who received acupuncture showed improvements in the “General Fatigue” score on the Multidimensional Fatigue Inventory (MFI). They also reported less pain, less anxiety and depression, and an improved quality of life.

"I am quite excited with these results. They provide some good evidence of an effect of acupuncture for the management of a very debilitating and burdensome symptom for patients," said Dr. Molassiotis. "Acupuncture is a complementary therapy that not only can have direct effects on the symptom experience of patients, but also ... provide the opportunity [for] patients to be more involved with their symptom management and empower them more.