 By
Fay-Meling von Moltke Pao, DAc, BHSc, Hon.BA.
In the fall of 2003, the Canadian Cancer Society held its first
symposium on the impact of Traditional Chinese Medicine in the treatment
and prevention of cancer. The CCS spokesperson, Cheryl Rill,
acknowledged that despite the advances of western medicine in treating
cancer, there was still much more to be learned and that the
evidence-based society welcomed discussions about cancer from various
perspectives.(1)
The multiple benefits of acupuncture
As acupuncture and oriental medicine continue to gain acceptance in the
west, they are increasingly being used in conjunction with western
conventional medicine to treat a range of conditions, including cancer.
Acupuncture in particular has received much attention for its use in
cancer pain and post-operative and chemotherapy-induced nausea and
vomiting. According to an article by Dr. N. Samuels (2002) published in
the research journal, Harefuah:
Acupuncture's use in cancer patients has been recommended by the
American Cancer Society (ACS) for the treatment of cancer and
treatment-related symptoms. Pain, nausea, breathlessness, vasomotor
symptoms and limb edema have all been found to respond to this treatment
modality.(2)
Dr. Samuels stated further that acupuncture can act against carcinogens
(factors attributable to cancer development) through its ability to
reduce stress and enhance immune function.(2) Indeed, several cancer
centres have begun incorporating acupuncture for treating cancer-related
symptoms such as pain(3) and many patients have had significant results
in the reduction of their symptoms.(4)
Before describing how acupuncture can be effectively integrated into the
care of the patient, it may be helpful to first gain an appreciation of
what cancer is and the various western conventional therapies that are
often used in its treatment.
What is cancer?
As one of the leading causes of death in North America, cancer is a
disease that few can ignore. It arises from abnormal changes in the
genetic make-up of cells that cause them to multiply uncontrollably. The
abnormal cells then spread locally or to other regions of the body via
the lymphatic or blood circulation. Several factors are believed to
trigger the cell mutations that give rise to cancer. These include
hereditary susceptibility, immune dysfunction, increasing age, improper
dietary intake, extreme stress, hormonal therapy and environmental,
infectious, and therapeutic carcinogens (agents that are associated with
cancer development).(5,6,7)
Conventional treatment
Common cancer therapies include surgery, chemotherapy, radiation
therapy, immunotherapy, and hormonal therapy. While surgery involves the
physical removal of tumours, other treatments such as chemotherapy work
on inhibiting cell growth and multiplication. All these therapies can be
very effective and are often critical components to helping a patient
survive. Removing tumours through surgery and radiation can prevent
further metastases (cancer spread to other areas of the body) and
complications. Unfortunately, these and other treatments can be very
difficult for the body to process and recover from. Several of the drugs
used in chemotherapy are not only toxic to cancer cells but to healthy
cells as well and can cause mild to severe bouts of nausea. By depleting
the bone marrow and thus inhibiting the production of white blood cells,
red blood cells, and platelet cells, chemotherapies can increase a
person's risk of infection, cause fatigue and dizziness, and impair
wound healing respectively. Furthermore, chemotherapeutic agents can
cause hair loss and skin rashes from damage to the cells of the hair
follicles and skin.(5,6,7) Hormonal drugs such as tamoxifen (used in the
treatment of breast cancer), have also been shown to increase the risk
of thrombosis (blood clotting) and endometrial cancer.(7)
Therapies such as gamma knife radiotherapy and cyberknife involve
focused radiation to a particular part of the body and are sometimes
offered as an alternative to surgery. In addition, newer
chemotherapeutic drugs promise less toxicity and fewer side effects than
ever before (5,6,7). These advances are indeed encouraging. So where,
you might ask, does acupuncture and oriental medicine fit in?
Traditional Chinese Medicine
Traditional Chinese medicine (TCM), which consists of acupuncture,
Chinese herbal medicine, tuina (Chinese massage therapy), nutrition,
counseling, and physical exercise (such as Tai Qi and Qi Gong), is a
comprehensive medical system based on over three thousand years of
experience. The earliest drawings of tumours have been found on turtle
shells and "oracle bones" from the eleventh century B.C. Texts dating
from 200 B.C. have detailed descriptions of the quality of tumours and
their cause.(8)
Similar to conventional western medicine, TCM attributes cancer to one
or a combination of factors such as genetics, lifestyle, and
environment. Cancer is the accumulation of external or internal factors
or both, that create disharmony in the normal functioning of the body,
and combine to produce a diseased state (8,9). In ancient texts, it was
believed that factors such as extreme cold and intense sadness could
also lead to unhealthy conditions such as cancer.(8) When treating
patients, the TCM physician takes a complete inventory of the person and
considers such things as musculoskeletal abnormalities, energy level,
body temperature, complexion, sleep, appetite, diet, digestive
functioning, emotions, and overall lifestyle.
As described by Gordon and Curtis (2000) in Comprehensive Cancer Care,
Traditional Chinese Medicine takes a holistic approach to the treatment
of cancer:
The traditional Chinese medicinal treatment of cancer is based on the
principle of fu zheng gu ben. Roughly speaking, fu zheng means
strengthening what is correct, the qi, the forces in the body regulating
normal healthy development. Gu ben refers to strengthening and enhancing
the processes of regeneration and repair, which Chinese medicine locates
in the kidney. Traditional treatment includes removing toxins that may
contribute to cancer, increasing the flow of blood and qi, removing
undesirable accumulations of tissue that are the tumor, and restoring
self-regulation and balance among the jing, shen, and qi. The means that
are used - acupuncture, herbal and nutritional therapies, tai chi, qi
gong, tui na, and counseling - are each designed to further one or more
aspects of this process.(8)
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)
How does acupuncture work? The eastern and western explanations
In Traditional Chinese Medicine (TCM), the body is composed of an
intricate web of energy pathways known as "meridians". The twelve
regular and eight extra meridians help to maintain a balance of yin
(substances which nourish the body) and yang (related to activity and
function) within the body. Each meridian is named after the specific
internal organ that it encompasses and through which it passes. Through
these meridians, the internal and external aspects of the body are
connected.
When "qi" (vital energy) and "xue" (blood) flow freely through the
meridians, the body is in good health and can perform at its optimum.
However, if a particular energy pathway does not function properly, the
flow of "qi" and "xue" can become obstructed, hyperactive (excessive),
hypoactive (deficient) or even flow in reverse. This can affect the
function of the meridian's corresponding organs, which causes an
imbalance of the body's yin and yang, and ultimately affects the
functioning of the body as a whole.
From a TCM perspective, acupuncture stimulates specific points on the
body where energy collects and flows through the meridians and regulates
the overall flow of energy so that the body can return to a state of
balance and health.
From a western medical perspective, the insertion of hair-fine sterile
and disposable needles into the subcutaneous layers of the skin can have
profound influences on several regulatory systems. When used correctly,
acupuncture has neurophysiological affects (3) that can release
pain-reducing endorphins; affect the metabolism of serotonin, a
neurotransmitter (brain chemical) that affects both pain perception and
mood; and improve circulation and immune function.(8) Acupuncture
specifically works to relieve nausea by releasing chemicals that control
the vomiting centre in the brain as well as decreasing acid secretion
and inhibiting abnormal gastric contractions.(13)
So why are the needles inserted in specific places? According to Bruera
and Portenoy's Cancer Pain: Assessment and Management (2004), studies on
acupoints have shown that:
Many acupuncture points are also palpably detectable hollows or
anatomical tissue planes, which in Western theory, may signify easily
influenced zones of lymphaticoneurovascular bundles in the subcutaneous
tissue. Peripheral endings of cranial and spinal nerves, and
penetrations of neurovascular bundles through superficial fascia, have
been cited as morphological findings of acupuncture points.(14)
What to expect from an acupuncture treatment
Though the insertion of needles under the skin might not sound
appealing, the reality is that the fine needles cause little discomfort
or pain since they are inserted below the skin layer. Once the needles
are inserted, patients may feel a dull, heavy sensation accompanied by a
slight tingling or numbness in the local area of insertion, that usually
dissipates within a few moments. The needles are then retained for
approximately twenty minutes. Most people find this experience to be
quite relaxing and some may even fall asleep. After the acupuncture
session, the practitioner may also use other modalities such as tuina
(Chinese massage therapy) to complete the treatment. For chronic
conditions such as cancer, treatments will be regular (at least once or
twice a week) and adjusted according to the particular condition a
person is in.
Some final thoughts
Cancer is not a death sentence. It is a life-changing experience not
only for those who have it, but for others as well. Educating ourselves
as to what options are available for treatment and overall healing can
only improve our opportunities to live a healthier and happier life.
From providing adjuvant therapy for pain and associated emotional
aspects relating to cancer, to treating side-effects such as nausea and
decreased immunity arising from the more toxic and invasive conventional
treatments, acupuncture and oriental medicine are invaluable resources
that can guide the body towards a healthier state.
Our current medical system in the west comes from a background of
reductionism, where we reduce a person to the sum of their body parts.
This means that when treating a patient, there is a tendency to deal
with the parts rather than the whole. Furthermore, our focus in health
care has in large part been on treatment rather than prevention. While
these views have their place, a more pronounced shift towards
prevention, treating the whole person, and allowing an individual's
natural healing abilities to take part in the healing process, is
necessary if we truly want to promote health. Here is where the
integration of eastern with western medicine can truly make a
difference.
________________________________________
"Alas! The way of healing is so profound. It is deep as the oceans
and boundless as the skies. How many truly know it?"-Huang Di Nei Jing
(The Yellow Emperor's Classic of Internal Medicine).(15)
________________________________________
Fay-Meling von Moltke Pao, DAc, BHSc, Hon.BA, is a licensed
acupuncturist and practitioner of Oriental medicine in Toronto, Ontario.
After completing her degree in Biomedical Ethics at the University of
Toronto, she continued her studies and graduated from a four-year degree
program in Acupuncture and Oriental medicine from the Michener Institute
of Applied Health Sciences (recognized by ACAOM). In her practice, Fay-Meling
combines classical and modern acupuncture techniques with herbal
medicine, nutrition and diet therapy, counselling, tuina (Chinese
massage therapy), and qigong where appropriate.
"My aim is to provide patients with an integrative form of health care
that utilizes the best of eastern and western medicine. As such, I am
committed to working closely with other physicians and health care
practitioners involved in an individual's care, and enabling the
person's own healing abilities. I warmly welcome all patients to my
clinic."
-Fay-Meling von Moltke Pao
For more information on her practice and Acupuncture and Oriental
Medicine please visit her website at:
http://www.acupao.com
References
1. Vancouver Hosts Symposium on Traditional Chinese Medicine and Cancer
http://www.Acupuncturetoday.com. Accessed February 18, 2004.
2. Samuels N (2002) Acupuncture for cancer patients: why not? (article
in Hebrew) Harefuah. 141(7):608-610, 666. Click here. Accessed March 17,
2004.
3. Filshie J, Thompson JW. Acupuncture. In: Doyle D, Hanks G, Cherry N,
Calman K editors. (2004) Oxford textbook of palliative medicine-3rd ed.
NY: Oxford University Press. P. 410-424, 1093.
4. Johnstone PA, Polston GR, Niemtzow RC, Martin PJ (2002) Integration
of acupuncture into the oncology clinic. Palliat Med. 16(3):235-9 Click
here. Accessed March 6, 2004
5. What is Cancer? Click here. Accessed Feb. 18, 2004.
6. Holmes, HN (2001) Professional guide to diseases. 7th ed.
Springhouse, PA: Springhouse Corporation.
7. Tierney LM, McPhee SJ, Papdakis MA (2004) Current medical diagnosis
and treatment 2004. 43rd ed. NY: The McGraw-Hill Companies Incorporated.
8. Gordon JS, Curtin S (2000) Comprehensive cancer care: integrating
alternative, complementary, and conventional therapies. NY: Persus
Publishing.
9. Li P (2003) Management of cancer with chinese medicine. St. Albans,
UK: Donica Publishing Limited.
10. Mak E. Acupuncture in Cancer Treatment. Click here. Accessed Feb.
18, 2004
11. Poulain P, Pichard Leandri E, Laplanche A, Montagne F, Bouzy J, and
Truffa-Bachi J (1997) Electroacupuncture analgesia in major abdominal
and pelvic surgery: a randomized study. Acupuncture in Medicine. XV (1),
10-13.
12. Aldridge S. Acupuncture helps breast cancer patients (abstract).
American Society of Anaesthesiologists Annual Scientific Session, 2001.
13. Samuels N (2003) Acupuncture for nausea: how does it work? (article
in Hebrew) Harefuah. 142 (4):297-300, 316. Click here. Accessed March
17, 2004.
14. Bruera ED, Portenoy RK (2004) Cancer pain: assessment and
management. NY: Cambridge University Press.
15. Ni M (1995) The Yellow Emperor's Classic of Internal Medicine: A New
Translation of the Neijing Suwen with Commentary. Boston, MA: Shambhala
Publications, Inc.
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