Liver Cancer
In Traditional Chinese Medicine (TCM) Cancer can be the result of chronic stagnation of qi, blood or phlegm or a trail of mistreated diseases stemming back to childhood years. Although there is no ‘real’ word for ‘cancer’ in TCM terms there have been recordings of its life threatening existence for many thousands of years.
The main principals of TCM treatment of Cancer are as follows:
1- To fight fire with fire: using toxic herbs to treat a toxic disease
2- Promote blood circulation and remove blood stasis
3- Soften hardness to dissipate stagnation
4- Strengthen and consolidate body resistance
TCM recognises that cancer should be treated very differently and the application of these four principals will vary. TCM treatment can be used at all stages of disease from the prevention of cancer to the fight against cancer to recovery of cancer. TCM has also proven its value to relieve any presenting symptoms and support rehabilitation during Chemo or Radio therapy.
In the case of Bed number 31 Male with Lung Cancer he has accepted Chemotherapy treatment for the second time and is now experiencing some swelling and oedema of the face and feet.
Herbs such as Fa Ban Xia, Fu ling, Huo Po, Bai Zhu and Sha ren can be used to treat this adverse reaction.
Liver Cancer is one of the most prominent cancers seen in The Guangzhou
Case Review
PATIENT: Bed 32 Male 66 y.o.
INITIAL PRESENTATION: Painful abdominal mass with distension.
PRIMARY SYMPTOMS: Decreased appetite, emesis, swelling of the lower limbs, deep breathing, flank pain, dizziness, headache, yellowing of the eyes, cough and dry stool.
Tongue: Dark red, light thin white coat
Pulse: R: Wiry L: Wiry in the guan position but weak in the cun and chi positions
HOSPITAL TREATMENT: Further investigation shows cancer of the liver is present for a 3rd time. Patient will undergo treatment of chemotherapy, a course of TCM formulas and dietary advice.
PROGNOSIS: ok
TCM DIAGNOSIS: Liver blood stagnation, Liver Qi Excess with Spleen Deficiency.
PATHOGENESIS: The liver is responsible for the smooth flow of Qi, the storage of blood and yin and yang partnership with the gall bladder. Primarily stagnation occurs due to a disruption to the liver qi or blood. This stagnation can manifest in distending hypochondriac pain as well as oppression or stuffiness of the chest. Blood and qi work in unison to support, nourish and produce each other, injury to one will result in injury to the other.
Excess liver often leads to liver fire or liver yang rising causing headaches or dizziness. The liver fire could also affect the bowels causing constipation.
The liver opens to the eyes and aids the flow of bile from the gall bladder, malfunction of the liver will also result in poor vision and jaundice.
According to five phases the liver and spleen also share a close relationship. If the liver is in excess it will surely cause deficiency of the spleen manifesting in poor digestion and appetite. When spleen deficiency occurs there is disruption to the transformation and transportation of fluids, oedema to the lower limbs is a common presentation of this.
IN PATIENT PRESCRIPTION:
Wu Zhua long 30g
Ba Yue Zha 10g
Nu Zhen Zi 15g
Fa Ban Xia 15g
Fu Ling 15g
Dang Shen 15g
Mai Ya 15g
Bai Zhu 15
This prescription aims to support the spleen, smooth the flow of Qi and dissipate mass. Wu Zhua long and Bu Yue Zha are used for their anti cancer effects in particular Wu Zhua Long, it enters the spleen, liver, lung, large intestine and bladder. Ba Yue Zha also regulates the smooth flow of liver Qi, dissipates mass due to stagnation, promotes blood circulation and relieves pain. Yu Jin activates blood, breaks up stasis and moves Qi of the chest and abdomen relieving pain also soothes the liver and gall bladder and reduces jaundice. While it is good to break up blood stasis caution should be taken not to add too many herbs with this action so as not to encourage the liver to erupt and bleed.
Nu Zhen zi is good for dizziness, poor vision and to treat the fluids that may be damaged as a result of liver fire.
These first 3 herbs are bitter and cool which is helpful to control liver fire but can be harmful to the spleen. The remaining ingredients of the formula with the exception of Bai Zhu which is warm all possess a neutral property work that work to tonify and nourish the spleen. One way of treating an excess condition is to tonify the deficiency to encourage harmony and balance within the body. Fa Ban Xia, Fu ling, Pei Lan and Bai Zhu all work to support the transportation and transformation of fluids resolving oedema and the attack of phlegm. Fa Ban Xia also possesses a quality to dissipate mass. Mai Ya, Bai Zhu and Dang shen support the digestion. Dang Shen not only aids digestion but supports the centre enabling Qi flow and nourishes the fluids.
FURTHER TREATMENT:
If Jaundice becomes the predominant complaint the formula Yin Chen Wu ling San or Long Dan Xie Gan Tang can be prescribed as a base formula.
Once the cancer has dissipated I would continue to concentrate on strengthening the spleen and stomach as well offer support to the eyes and the smooth flow of liver Qi. Some suggested base formulas are Chai Hu Shu Gan San and Xiao Yao San. I would also aim to help reduce the blood spots apparent under the skin.
My suggested formula is as follows:
Tian Qi 5g– Enters the liver and stomach, relaxes the blood vessels – skin condition, stops bleeding, reduces pain and clears blood stagnation. Care is taken with this herb however its function to stop blood is more powerful then its function to promote blood circulation.
Yu jin 10g– Moves blood stagnation, soothes the liver and gall bladder and reduces jaundice
Bai Shao 15g – nourishes the blood, calms the liver yang, relieve pain due to stagnation and disharmony between the liver and the spleen.
Chen pi 10g – Tonify the spleen, regulate middle Qi and improve the appetite.
Mai Ya 15g– Aid digestion after sickness, soothe liver Qi and tonify the spleen
Bai Zhu 10g – Supplement Qi and strengthen the centre
Fu Ling 10g – Tonify spleen Qi and help the transformation and transportation of fluids
Dang Shen 15g – Nourish the fluids, boost spleen Qi and tonify lung Qi – the lung may experience some deficiency after the spleen is deficient for a long period of time.
Chai Hu 10g – Soothes liver Qi and harmonizes liver and spleen as well as the interior and exterior
Mi Meng Hua 6g– Enters the liver channel to guide herbs to the eyes
Wu Wei Zi 15g - Scientifically improves liver function
Gan Cao 10g- Harmonises toxins from other herbs and reinforces the spleen, Qi and blood.
External treatments can also be used:
I would also look at point injection to increase the appetite, stop vomiting and support the harmful effects of chemotherapy.
Herbal patches to help with the pain, Herbal Fumigation to alleviate oedema and ear seeds to treat constipation and support vision and stop pain.
Acupuncture could also be used with the patient’s approval to the following acupoints: Gan Shu, Pi Shu, Wei Shu and Ge Shu, Taichong, Neiguan, Zusanli, Tian Shu, Zhangmen or Qimen.
DIETARY AND LIFESTYLE ADVICE:
I would advise against smoking, alcohol, elicit and prescription drugs to avoid over working the liver. Reduce the intake of meat, saturated and trans fats, preservatives, additives such as colourings and salt.
Eat plenty of vegetables and fruit including leafy greens and mung beans that nourish the liver or possess good amounts of vitamins A, C, or E. Never eat food that is past its use by date.
Eat to support the spleen and do not overburden with heavy, hard to digest foods or food in large quantities.
Cancer fighting foods are recommended such as kale, cabbages, carrots, grapes healthy oils and fish high in omega 3 oils.
A dietary recipe suggestion is Lu Dou and Lian Zi Soup: 150g of Lu Dou, 60g of Bai Lian Zi and 60g of Yi Yi ren. Rinse herbs and soak for 30minutes. Pour soaking water into pot with the herbs and boil a little sugar may be added for taste during the last 15minutes of cooking time.
Try to allow for 10-20mins of Qi Gong or Tai Chi per day to encourage a smooth flow of Qi within the body.