Chinese medicine and cancer : Introduction

One of the things I would like to do as a physician is help people who have various types of cancer.  I realize that even this statement will be regarded by some as problematic.  Some say that Chinese medicine doesn’t recognize “cancer” as such and that Chinese medicine physicians shouldn’t “specialize” in treating any particular condition.  I recognize the points in that argument.  However, my partner and I feel a great affinity towards people who have had their lives touched by what Western medicine calls “cancer” in all its variations.  It is an affliction that creates great hardship in the lives of many, regardless of what we call it.

I will write a series of posts detailing what I learn as I investigate the range of syndromes that we commonly call cancer.  I will be looking at it from different angles.  I am fortunate in that I have a variety of approaches to directly observe.  Apart from what I will be able to observe in clinic and learn directly from professors, I will be doing literature searches and conversing with my many colleagues flung across the world via the Internet.  I hope this series will be helpful for many types of people including my peers and other people who are seeking information about herbs, acupuncture and cancer.  I am particularly interested in starting conversation around this issue, so I will try to end every post with a question – please leave your answers (however tentative) in the comments.

What is cancer? Basic Western and Chinese perspectives

From a Western perspective, the most basic way to describe cancer is simply as a disease process in which body cells begin to grow out of control.  In general, this happens because of DNA in a cell that becomes damaged and is either (a) repaired, or (b) mitigated by controlled death of the damaged cell.  This can happen for many reasons.  Further, cancers in various parts of the body grow at different rates, in response to different environmental triggers.  This, of course, results in the variable survival rates, symptoms and other features of different cancers.  You can have cancer in virtually every part of the body.  Causes range from inherited damage to DNA to inhaled toxins to accumulation of toxic by-products in the body and countless other factors.  Western medicine has begun to understand cancer fairly well, but the fact is that there is still a ton of work to do.  There are a huge number of foundations and government agencies working on finding “cures” for various types of cancer.  If you want to learn more about Western perspectives on cancer, or to find resources in that realm – a great starting point is the American Cancer Society.  You might also want to check out the National Cancer Institute.

In Chinese medicine, cancer is most often described as either a phlegm or a blood stasis accumulation (or both).  Ultimately, cancer is not talked about as such – instead there is a description of masses or tumors.  In this way, treatment generally progresses in a manner very similar to other masses and tumors.  It is interesting that early on in Chinese medical history, a fairly nuanced way of classifying tumors emerged, based on the color, size, location, painfulness and other features of the mass and its local effects.

As with any other disease, we should start with the basics when we are looking at cancer.  Using the essential Ba Gan (Eight Pillar) differentiation can help us get a handle on the disease process we are confronting.  Is the imbalance of a Yin or Yang nature?  Is it primarily hot or cold?  Does it seem to be external (as in a cold) or internal?  Is it deficiency or excess?  While I’ve heard many simplistic answers to these questions when discussing cancer, I think the truth is probably more complicated.  While masses are undeniably Yin in nature, a festering tumor or one in metastasis clearly has Yang qualities.  While many cancers have the cold and cooling quality we would expect from a Yin-like disease, others burn brightly and cause great heat both superficially and internally.  Regarding the internal or external nature, I think it goes without saying that all cancers are internal – regardless of whether we want to think of them of having been ultimately caused by a penetrating external pathogen.  Cancers, too, may have deficient and excess qualities.  I’ve obviously answered no questions here, but I’m starting to clarify for myself the deep complexity in a disease with such far reaching effects.

What are the standard approaches to treatment of cancer? Western and Chinese perspectives

Many of us know that the standard treatment options for cancer in the Western medical model are surgery, chemotherapy and radiation.  Some folks choose all three of these options, some only one or two.  Some people have reported that Western medical doctors (especially at forward-thinking cancer specific research centers) are doing more recommendation of dietary and lifestyle adjustment as a way to manage both the disease and the side effects of the strong Western treatments.  This points out the deepest problem with Western medical treatment of cancer – the side effects.  Surgery itself has its own recovery process which can be quite difficult for some – particularly those who are quite weak, elderly, or fighting some other disharmony in their body.  Radiation and chemotherapy both use agents that are quite toxic for the body.  The side effects are many, including the very visible loss of body hair, thinning of the skin surface and often debilitating loss of appetite, nausea and fatigue.  Some people consider these to be necessary evils, since these treatments can be quite effective in eradicating some cancers.  Still, many people yearn for alternatives – regardless of whether their particular cancer is effectively treated by these methods.  Avoiding side effects, improving quality of life and increasing the effectiveness of Western treatments top the list of desired outcomes when people seek Chinese medicine and other natural therapies when treating their cancer.

Chinese medicine uses the basic set of powerful and versatile tools to treat all disease.  A full treatment protocol from a Chinese medicine physician will include a Chinese herbal formula, an acupuncture prescription (perhaps involving cupping, needling, moxibustion or a combination of these and other manual therapies) and may also include lifestyle counseling, dietary advice and prescribed Qigong or Taiji movements appropriate for the presenting condition.  For phlegm and blood stasis accumulations, the standard treatments will involve both resolving/dissolving the masses directly, promoting general movement throughout the Qi and Blood flow of the body and supplementing any deficiencies that might be accompanying the condition.  The dietary advice will be specific for the person, but will probably advise against refined foods, fatty foods and very cold foods – as is the case for most serious conditions.  Obviously, a variety of approaches exist – which is what I hope to investigate and communicate as this series progresses.

The many dimensions of the human being and their relationship to cancer

Yesterday, a patient remarked to me how disregarded she felt in the conventional Western medical world as she struggled with serious illness.  She felt as though the patient had no interest in her as a person and saw her primarily as a carrier of some “target” to be measured and attacked by the physician.  This most certainly impacted her healing process.  She remarked how different naturopathic and Chinese medicine practitioners feel to her – she believes they/we see her as a complete person.  Most of all, she feels like we treat her as a person at all.  With a disease like cancer that is still one of the top 3 causes of death in most industrialized nations, I feel that it is easy for physicians to become detached.  This may be a form of self-preservation.  To become deeply connected with a patient and then have them die is certainly a difficult occurence.  However, I believe as a physician of any modality you have a responsibility to learn how to take care of yourself in such a way that you are able to handle the diverse pressures involved.

Like any disharmony, cancer impacts people on as many levels as they have.  Cancer certainly has profound physical effects, any Western treatments they are using have their own physical impacts as well.  Cancer also impacts people emotionally.  This is true of course in the sense that people are having to reckon with their mortality and the range of issues that comes along with that reckoning.  But, from a Chinese perspective, the blockages that come about because of the actual existence of the mass and its Qi and Blood disturbing effects will almost surely be detrimental to the emotional balance of the human being.  There are also social and spiritual effects on the person.  All of these need to be addressed by the physician and patient in concert if true healing is to take place.

Hope, quality of life and survival

A frequently terminal disease like cancer brings up so many questions, it boggles the mind.  There’s nothing simple about it.  For instance, should survival be pushed for at any cost?  That certainly seems to be the mindset of many people in the medical profession and beyond.  What about quality of life?  What is included in quality of life?  If a person cannot feed themselves or use the bathroom by themselves, but can still engage in lively conversation and interact with loved ones – do they have a decent quality of life?  While our focus must always be on promoting balance and well-being regardless of a patient’s disease state, we need to be thinking about these questions if only for ourselves.  How do we provide a sense of hope and groundedness when the prognosis seems dire?  On a more base level, what responsibilities do we have legally and socially when it comes to treating or not treating patients based on the severity of their condition?  These are all questions we should be ruminating and discussing with eachother as a community.  I’m sure you have ideas of your own, or perhaps have more questions.

A question for the readers: In your work with people who have cancer (or, if you are not a practitioner, in your personal experience with people with cancer) what are the most important things to keep in mind as you interact with the person?  How can you create a healing atmosphere for people who are facing a disease that is often (often erroneously) considered to be a death sentence?  Go ahead and share your thoughts in the comments.  Don’t worry – thinking out loud isn’t penalized here.  :)

Thanks for reading.

Eric

Tagged as: Cancer, compassion, cure, death, disease, patient care, quality of life, western-science