– Henry McGrath MA MRCHM MBAcC
The author is a practitioner of Chinese Herbal medicine and acupuncture in the UK, specialising in the management of cancer. He is the Acupuncture Course Leader for the College of Naturopathic Medicine. He spent two weeks in China, and observed the herbal treatment of around 70 patients with cancer. Some of these patients received conventional or western treatments, such as surgery, chemotherapy and radiotherapy, while some received only Chinese herbs. He saw Chinese medicine giving great relief for a wide range of symptoms, including pain, nausea, lack of appetite, liver and kidney dysfunction, immune deficiency, emotional problems and insomnia. Several doctors also claimed that herbal medicine helped prolong the life expectancy of some patients, although the author saw no evidence for this that would be accepted by western research standards.
The author believes that Chinese integrated approach has much to offer those in the West with cancer.
In September 2006, the author led the College of Naturopathic Medicine acupuncture study trip to China. CNM students were given placements in Nanjing Hospital of Traditional Chinese Medicine, and had the opportunity to learn first hand from expert Chinese doctors. Students worked with a wide range of disorders, including paediatrics, sciatica, neurological disorders, and paralysis. By the end of the placements they had gained much confidence in their ability to use acupuncture effectively.
Between supervising the students, the author spent time in Chinese herbal medicine oncology wards. He spent time in Nanjing Hospital of Traditional Chinese Medicine, Oncology Outpatient Department, and in the Oncology Inpatient Ward of Dong Feng Hospital, Beijing.
As in the West, patients have the opportunity to receive conventional or western treatment of their cancer. This includes the full range of scans and blood tests, as well as surgery, radiotherapy and chemotherapy. However, patients also have the opportunity to be referred for Chinese herbal medicine in addition to their western treatment, which many take up.
The first thing that struck me about the Herbal Medicine Oncology Clinic in Nanjing was that the small room was constantly full of people. As well as the Doctor and patient, several other patients waiting their turn would be standing around openly listening to the consultation. Patients listened unself consciously to each others stories, sometimes even joining in to each others consultations. This arrangement struck me as a marked contrast to the hushed, strictly private oncology consultations seen in the West. Whereas the western approach can leave patients feeling very isolated, the Chinese way seemed to offer mutual support to patients. There did not seem to be a need for a mutual support group.
The vast majority of the patients I saw had received surgery for their cancer. A slightly lesser number had at least started to receive chemotherapy or radiotherapy. However, some of these patients had been unable/ unwilling to complete the course of treatment because of its side effects. For most of these people, the herbal medicine was perceived as an alternative to a treatment they were unable to take. For many others, the herbal medicine was perceived as supporting the conventional treatment, in some cases allowing them to complete it.
The complaints treated by herbal medicine
In the following discussion it must always be born in mind that Chinese herbal medicine treats the whole person. It pays special attention to nourishing the qi, the vital force, in order to boost the patients innate ability to fight disease, both physically and mentally. The tongue and pulse are always studied carefully to give an accurate diagnosis, on which the treatment will be based. Herbal formulae are be carefully constructed to match the energetic pattern of the patient, and will usually contain about fifteen to twenty herbs. The dose will normally be about 200g per day of dried herbs, which must be boiled by the patient. Bearing in mind the above caveat about herbs treating the whole person, for the sake of convenience we shall discuss the treatments by groups of primary symptoms, as follows:
1.nausea, digestive disturbance and fatigue
2.insomnia and emotional problems
4.liver and kidney impairment
Nausea, digestive disturbance and fatigue
The enjoyment and sharing of food is central to Chinese life, and to the Chinese persons sense of well being. Chinese people are also keenly aware of the key role of the digestive system in maintaining good health. In Chinese medical theory, the digestive system transforms food into qi. If surgery, radiotherapy or chemotherapy interferes with the digestive function, it will therefore undermine the production of the vital force. This can lead to fatigue, and may impair the patients ability to fight their cancer. Many patients therefore seek help from herbal medicine when their digestion is upset by biomedical treatment.
It was very moving to see that most patients who had taken herbs for their digestion reported great improvements. The reaction of one man, well into his seventies, seemed to speak for many: when asked whether the herbs had helped his digestion, his wrinkled but bright face lit up, and he gave a contented pat on their abdomen. It seemed that his appetite for food reflected his appetite for life, regained through herbal medicine.
There are many dozens of Chinese herbs that soothe the digestion, and promote the production of qi. The herbs are selected according to the exact nature of the diagnosis. Those most commonly used in the treatment of cancer include astragalus (huang qi), hawthorn (shan zha), seeds of Jobs Tears (yi yi ren), and medicated leaven (shen qu). This latter herb contains many enzymes which help the digestion, and it also helps protect the stomach against harsh chemicals such as those used in chemotherapy.
Insomnia and emotional problems
Obviously being given a diagnosis of cancer can create a huge emotional strain. It may create anger, grief, worry, and a huge range of other emotions. In Chinese medicine, each emotion affects a specific organ: for example, anger affects the liver, grief affects the lungs, and worry affects the digestion. These strong emotions can disturb the sleep, making the patient even more tired, and draining the strength they need to fight their cancer. Chinese medicine therefore placed great stress on addressing the emotional concerns of patients, which helps maintain healthy organ function. Chinese medicine has a whole category of herbs which calm the mind, and there are herbs for each specific emotional problem. For example, Chinese lily (bai he) helps grief; biota seeds (bai zi ren) sooth the heart and help sleep; wild date seeds (suan zao ren) calm anger, soothe the liver and help sleep. This latter herb contains a chemical called jujuboside, which is a natural sedative and hypnotic. Interestingly, there is evidence that it also functions as a cardiotonic, treating heart irregularities.
Radiotherapy, according to Chinese medicine, tends to overheat the body and dry it up. In Chinese medical terminology, it is said to deplete the yin. Certain herbs are used to nourish the yin, in order to counter the side effects of radiotherapy. These include Chinese asparagus (tian men dong), ophiopogon grass (mai men dong), and adenophora (sha shen). The latter herb is particularly good at soothing the mucous membranes of the lungs where they have been damaged by heat and dryness from radiotherapy. It is an antitussive (it helps coughing), and helps to bring body temperature back to normal.
Chemotherapy can kill the white blood cells, which fight infection. It is therefore important to try and maintain the white blood cell count during treatment. Certain herbs can help with this, and several studies show that for example astragalus (huang qi) enhances the production of white blood cells (Chen and Chen p852).
One study looked at the use of moxibustion in maintaining white blood cell count in patients with leukopenia (reduction in immune cells). (Moxibustion involves burning the herb artemesia at acupuncture points). A group of 91 patients were divided into two groups, one of which was given moxibustion and the other which was not. Of the group receiving moxibustion, 47% had a pronounced increase in white blood cell count, whereas in the other group only 5% saw a pronounced rise in their white blood cell count (Li Peiwen, p97)
Liver and kidney impairment
In the fight against cancer it is important to maintain the function of these organs. They both help to cleanse the body of toxins, and so are crucial in maintaining health.
When the liver is having to break down the toxins from chemotherapy, it produces more enzymes to try and do this, which puts it under stress. At least sixteen Chinese herbs have been shown to help keep the level of liver enzymes down, including schizandra (wu wei zi), angelica (dang gui), gentian (long dan cao) and liquorice (gan cao) (Li Peiwen, p109).
Chemotherapy and radiotherapy can also lead to kidney impairment. This can cause a wide range of problems, such as oedema, and a build up of toxins in the body. This can lead to high blood pressure and other complications.
One study divided a group of 86 patients undergoing chemotherapy into two equal groups, only one of which received Chinese herbs. Only the group receiving the herbs demonstrated a maintained renal function (measured as no significant change in levels of blood urea nitrogen and creatinine) (Li Peiwen, p123).
Using herbs to attack cancer cells directly
In addition to using herbs which manage the side effects of conventional treatment, herbs are used which are thought to attack the cancer directly. Ever more studies are being conducted on the anti cancer effects of Chinese herbs, which are too numerous to mention here. Herbs attracting worldwide attention include Oldenlandia (bai hua shi shi cao), circuma (e zhu, which is given intravenously to cancer patients in China), and seeds of Jobs Tears (yi yi ren). This last herb is a variety of maize, consumed as a staple food in South East China. Studies show that cancer rates are very low in the areas where this plant is consumed. Compounds in the plant have been found to inhibit the growth of tumour cells, and to increase the expression of genes FAS and Apo 1, which help inhibit the growth of tumour cells (Zhejiang University Press). The herb has been synthesised into a drug called Kanglaite, which has received FDA approval for a stage II trial in the USA.
In China, herbs are an integral part of the management of cancer. As well as treating the side effects and improving the quality of life, herbs are used to maintain the patients overall sense of well being and energy. Herbs are also used to try and attack the cancer directly, and thereby to strive to increase the life span of the patient.
About the author
Henry McGrath has been practising Chinese medicine for over ten years. He runs his own clinic in Bristol, and also works at Penny Brohn Cancer Care. He is the acupuncture course leader at the College of Naturopathic Medicine, and has also taught Chinese medicine at various other colleges and universities. He is the author of The TCM Workbook, an introduction to Chinese medicine theory.
Chen J K and Chen T T: Chinese Medical Herbology and Pharmacology, Art of Medicine Press, 2004
Li Peiwen: The Management of Cancer with Chinese Medicine, Donica, 2003