Oriental Medicine: An Integral Part of Integrative Oncology, Part Two
By Kabba Anand, DAc, LAc, Dipl. Ac., Dipl. CH
In conventional medicine, cancer is viewed as a group of cells that has outgrown environmental constraints and control mechanisms. These cells become abnormal and are then considered to be foreign to the body.
The main treatment strategy is to kill cancer cells using aggressive therapies. In the practice of acupuncture and Oriental medicine (OM), cancer is viewed as a part of a pattern of disharmony both stemming from and affecting the entire system (body-mind-spirit). In Chinese medicine, patterns of disharmony typically encountered with cancer involve phlegm, toxins, deficient qi, and blood and blood stagnation. Many practitioners also find that emotional instability can contribute to the imbalance. The main treatment strategy is to restore health through stabilization of an imbalanced system.
It would be a challenge to find a situation where acupuncture, herbal medicine, qigong and nutritional therapy would not be supportive of a cancer patient. "Recent evidence suggests that many traditional Chinese medical therapies are effective for the supportive care of cancer patients."1 Herbal medicine can be used to relieve nausea in chemotherapy patients. Some patients are intolerant to the side-effects of standard antiemetic or analgesic drugs, and can benefit tremendously from acupuncture and herbal compounds. Herbs such as radix ginseng, ganoderma, radix astragali membranaceus, radix angelicae sinensis, cordyceps sinensis, and fructus lycii are immune-stimulating agents that "have been shown to enhance the body's defense mechanisms."1
Acupuncture is often used to relieve cancer pain, reduce fatigue from chemotherapy, alleviate nausea, and control stress-related anxiety. "Multiple animal and clinical studies have also suggested that acupuncture has a positive immune-modulating effect in cancer patients."1 Acupuncture and moxibustion have shown the ability to increase leukocyte counts in patients with chemotherapy-induced leukocytopenia.2 University of California researchers have found that Chinese herbs used with cancer patients "reduce the tumor load; prevent recurrence or formation of a new primary cancer; bolster the immune system; enhance the regulatory function of the endocrine system; protect the structure and function of internal organs and glands; strengthen the digestive system by improving absorption and metabolism; protect bone marrow and hematopoetic function; and prevent, control, and treat adverse side-effects caused by conventional treatments for cancer."3
Qigong gives patients an opportunity to actively participate in their treatment, stimulates the lymphatic system, and improves strength and mental outlook. "Qigong therapy should be seriously examined and be considered as an important supplemental (treatment) to the conventional cancer treatment ... Studies ... have demonstrated consistent results for its inhibitory effect on cancer growth and metastasis, in both in vitro and in vivo studies, as well as in clinical observation."4
As acupuncture and OM practitioners, we have supported the health of patients in almost every stage of cancer in its multitude of forms and expressions. At one extreme, patients come to improve their "quality of life" when conventional therapies such as surgery, chemotherapy and radiation have not been successful in arresting the growth and spread of cancer. At the other side of the spectrum, patients come after early detection and want to use unconventional but traditional therapies such as acupuncture, Chinese herbal medicine, qigong, meditation, and dietary modification before considering more invasive approaches. In recent years, more patients are wanting to combine therapies, using the best of several disciplines, in order to maximize benefit while minimizing risk as well as the potential side-effects of conventional therapies.
Although research has begun to show great promise and benefit from using acupuncture and Oriental medicine as an integral part of cancer care, at first there was little or no communication between practitioners of conventional and traditional medicine, and CAM providers. Little was known about the synergy and/or conflict various therapies might create when used in common, and few practitioners of acupuncture and Oriental medicine were working in hospital or integrative settings. Patients had to decide for themselves, with little or no guidance, what to do, when, and for how long. However, a new approach is rapidly emerging, providing the opportunity for collaborative and integrative care.
In Los Angeles, at the Center for Health and Healing at St. Vincent's Medical Center,5 cancer patients, as well as those with other medical conditions, can receive acupuncture and Oriental medicine. The center, which is an independent department in the hospital, got its start in 1999 as a program in the Cancer Treatment Center through a generous grant from the Daughters of Charity Foundation that focused on reducing the side-effects of radiation and chemotherapy. David Boyd, PhD, LAc, former academic dean of Samra University of Oriental Medicine, helped to launce the program, and until January served as executive director for the center. In a recent interview, he told me, "These are the kinds of programs that should be set up in every hospital in the country." Resident oncologists Drs. Amand Bouzaglou and Peter Kennedy were strong supporters of the program, and in 2002 it evolved into a full-fledged department within the hospital. One program, through grants, treats low-income patients diagnosed with cancer and other diseases. The grant covers the cost of acupuncture, herbal medicine and stress management. The center provides over 2,000 treatments each year in this program, and is currently coordinated by Victoria Blake, RN, LAc. Another program, which is fee-for-service, incorporates acupuncture, herbal medicine, stress reduction, yoga and pilates, and focuses on preventative care.
Another recently launched organization is the Society for Integrative Oncology (SIO),6 a nonprofit, multidisciplinary organization for health professionals committed to the study and application of contemporary therapies and botanicals for cancer patients. SIO has scheduled the world's first international conference for oncology professionals on integrative therapies and research7 in New York City this Nov. 17-19. I have consented to serve as an abstract reviewer for the conference. On Friday, the 19th, a satellite conference will be held on "Acupuncture in Oncology Practice and Research." The keynote speaker for the satellite conference will be Helene M. Langevin, MD, LAc, who will speak on "Acupuncture Mechanisms: Scientific Understanding of the Mechanisms by Which Acupuncture Works." Memorial Sloan-Kettering Cancer Center (MSKCC), a leader in developing SIO and the conference, will hold a 2-1/2 day course for acupuncturists in February 2005, and will address strategies for working with cancer patients.8 The optional half-day is for those aiming to work in hospital settings. SIO President Dr. Barrie R. Cassileth, who heads the Integrative Medicine Service at MSKCC, recently told me in an interview, "Integrative oncology is a synthesis of the best of complementary therapies and mainstream health care. Acupuncture plays an important role, as it can reduce many of the difficult symptoms associated with cancer and cancer treatment."
On Maui, efforts are underway to create a completely new environment for health and healing. Malulani Health and Medical Center9 is a proposed state-of-the-art integrative health facility, incorporating complementary, folk and alternative medicine, which would include a 200-bed acute-care facility. Its philosophy and approach will be to have multidisciplinary panels determine what therapy/therapies constitute appropriate care and then review, monitor and adjudicate potential treatment conflicts between conventional and traditional medicine. In the hope of realizing this dream, I have volunteered to serve on the center's Mission and Programs committee. I envision that Malulani one day may offer state-of-the-art integrative oncology treatment options where, for example, patients taking nutriceutical and herbal support can be guided in meditation prior to their chemotherapy in order to relieve anxiety, then receive acupuncture immediately afterwards to reduce or eliminate potential side-effects. Ron Kwon, MD, president and chair, told me recently: "I think your vision of chemotherapy treatment options is a wonderful one, and one we plan to implement at Malulani and offer to our patients."
It has become obvious that new treatment strategies and approaches that allow for collaborative and integrative solutions are essential as we continue to face the challenging and complex patterns of disharmony that patients with cancer often exhibit. The time has come to put aside differences in training and philosophy, and instead broad our understanding through collaboration while integrating and expanding our skills and services, thus creating a new paradigm of medicine that is guided by the wisdom and principles of traditional medicine, yet encompasses, embraces and integrates conventional treatment. We are the pioneers!
Wong R, Sagar CM, Sagar SM. Integration of Chinese medicine into supportive cancer care: a modern role for an ancient tradition. Cancer Treatment Reviews 2001;27:235-246.
Wei Z. Clinical observation on therapeutic effect of acupuncture at St 36 for leucopenia. Traditional Chinese Medicine 1998;18:94-95.
Beinfeld H, Korngold E. Chinese medicine and cancer care. Alternative Therapies September/October 2003;9(5).
Chen K, Yeung R. A review of qigong therapy for cancer treatment. Journal of International Society of Life Information Science 2002;20(2).