An Oriental Medical Physician’s Framework for the Understanding and Treatment of Cancer

6 An Oriental Medical Physician’s Framework for the Understanding and Treatment of Cancer

Within any paradigm, for any practitioner, an understanding of cancer and its treatment is a formidable prospect. Voluminous information has, must and certainly will continue to be written about it. In this chapter, I aim to provide the practitioner of Oriental medicine with a basic outline and a general thinking approach to the pathophysiology and treatment of cancer for clinical use.

Millions of people throughout the world have been stricken with cancer’s devastating and life-threatening varieties. For the most part, the standard Western treatment entails the equally devastating treatments of chemotherapy or radiation. As with many diseases, the strength of allopathic (conventional) medicine is its specificity of knowledge at the molecular level, and the strength of Oriental medicine its ability to frame physiological processes and treatment plans in general terms. This complementary contrast becomes apparent when addressing the topic of cancer.

The powerful tools of Oriental medicine can be successfully applied to cancer patients, not so much to treat the cancer per se, but to treat the ravaging side-effects of its standard therapy. In doing so, not only are these side-effects diminished, but the vital energy of the whole person is also enhanced, resulting in general improvement in their quality of life.

This chapter is divided into two parts—the etiology and pathophysiology of cancer from Western and Oriental perspectives and then its treatment from those perspectives. Insight into its pathogenesis is important in providing valuable clues for treatment, be it with surgery, chemicals, acupuncture, or herbs and these options are all explored.

Cancer in Western and Oriental Medicine: Etiology and Pathophysiology

Unrestrained Tissue Growth

Normal healthy cells live in a complex, interdependent environment, regulating one another’s proliferation. Continual reproduction of cells is a natural part of life, however, there must be specific mechanisms to prevent any particular type of cell from reproducing to the maximum extent its environment will permit. In the adult body, cells are regulated in such a way as to maintain the size, shape, and functions of the tissues and structures of the body. Normally, the cells of the body multiply and divide in a gradual and orderly fashion. They respect each other’s boundaries and only grow when other cells wear out and die. Cancer cells however, will continue to grow right over each other and over healthy cells and can suffocate normal cells with their aggressive growth and overcrowding.

The regulating mechanism of the cell is its DNA. DNA is coding material, which, among other things, guides the cell in the manufacture of new components. There are many mechanisms that cause mutation of DNA and the breakdown in the normal control of cellular reproduction that it directs. The full range of these causative factors is not known, but certainly there are chemical agents that appear responsible for certain cases, such as tumors. Emotional factors may play a part, perhaps by modulating hormone levels. Toxins and viruses may also be implicated. In some cases, sunlight damages the DNA.

The following factors likewise appear to be possible causes of cancer: chronic electromagnetic field exposure; genetic mutation; chronic stress; sick building syndrome; ionizing/nuclear radiation; pesticide/herbicide residues; industrial toxins; polluted water, chlorinated water, fluorinated water; tobacco and smoking; immune-suppressing drugs; irradiated foods, food additives, nutritional deficiencies; mercury toxicity, dental factors; nerve interference; depressed thyroid function; intestinal toxicity and digestive impairment, parasites; blocked detoxification pathways; free radicals; cellular oxygen deficiency/cellular terrain, oncogene, genetic predisposition and miasm.

The Harvard School of Public Health claims that other co-morbid factors that could reduce 2.5 million of the 7 million deaths per year in the United States alone due to cancer include smoking, alcohol, lack of exercise, diet, unsafe sex, contaminated needles, and obesity.

Stages of Growth

Not only do cancer cells ignore the usual controls and proliferate according to their own agenda, they also have the ability to migrate from the original site and invade nearby tissue. The resulting mass of new tissue forms a tumor, which is called a neoplasm. The pathology of cancer proceeds according to the following stages:

Tumor development begins when a cell within a normal population sustains a genetic mutation that increases its propensity to proliferate when it would normally rest. DNA repair genes that make proteins to correct errors may fail to do their job. Also, the presence or absence of repressor genes may not regulate cell multiplication.
The altered cell and its descendants continue to look normal, but they reproduce too much—a condition termed hyperplasia. After years, one in a million of these cells undergoes another mutation that further loosens control on cell growth.
In addition to proliferating excessively, the offspring of the altered cell appear abnormal in shape and in orientation; the tissue is now said to exhibit dysplasia. Once again, after a time, a rare mutation occurs that alters cell behavior.
The affected cells become still more abnormal in growth and appearance. If the tumor has not yet broken through any boundaries between tissues, it is called in situ cancer. This tumor may remain contained indefinitely, however, some cells may eventually acquire mutations.
If the genetic changes allow the tumor to begin invading underlying tissue and to shed cells into the blood or lymph, the mass is considered to have become malignant. The renegade cells are likely to establish new tumors (metastases) throughout the body via the blood system or the lymphatic system. The metastases may become lethal by disrupting a vital organ. Some cancers are more likely to metastasize than others. Melanoma often spreads to the lungs. Colon or rectal cancer frequently spreads to the liver and prostate cancer to the bones.
Locally, in a process called angiogenesis, new blood vessels may be formed when the malignant cells secrete chemicals that create a new blood supply for the tumor. With access to a steady source of nutrients, the tumor can grow indefinitely.

Types of Cancer

Many different types of cancer have three features common:

The cancerous tissues have the ability for continuous, indefinite proliferation.
The tumor may invade surrounding normal tissue.
The cancer has the tendency to spread throughout the body if it disengages from the primary tumor, travels through the circulatory system, and establishes colonies at distant sites.

Some tumors are benign; some are malignant. Benign tumors have an expansible growth pattern, enlarging locally within their host structures. They are usually contained within a capsule and do not spread to distant sites. Their cells are fairly well differentiated and cell turnover is slower. Malignant tumors on the other hand have an invasive growth pattern—over-running host stroma and other tissue structures. They can invade body cavities and blood and lymph channels, spreading to secondary sites (metastasis). Their cell replication is rapid and frequently abnormal. Poor differentiations and maturation of cells are typical, including a tendency to regress to a pre-differentiated or ancestor-type cell (anaplasia).¹

From a Western perspective there are some common signs and symptoms that suggest cancer², although due to the lack of a substantive mass in the early stages, pain may not be a symptom:

Chinese medicine recognizes a number of imbalances that contribute to the formation of cancer. It is primarily viewed as due to two leading pathological factors—stagnant blood and phlegm. Sometimes stagnant blood and phlegm may co-exist. They are also capable of engendering each other. Almost any stimulus may lead to the development of stagnant blood and phlegm. The most common include those listed below ³:

Disharmony of qi and blood, which leads to stagnation.
Development of and stagnation of phlegm.
Invasion by evil toxins. (In allopathic medicine this would include carcinogenic factors and viruses.)
Kidney and spleen deficiencies—pre- and postnatal qi deficiencies. (These could be viewed as Western genetic factors.)
The seven emotions or internal causes of disease (anger, joy, fear, fright, grief, anxiety, and thought [worry]).
The external causes of disease (evil qi)—wind, cold, damp, dryness, heat, summer heat. (These can also be subsumed under viruses and carcinogenic factors.)
The neutral causes of disease such as dietary irregularities of excessive drinking and ingestion of cold, hot, and greasy food, alcohol, and foods that lead to phlegm formation.

Since blood stagnation and phlegm are seen as two of the major contributing factors, the following are the corresponding treatment principles most commonly utilized when treating cancer by traditional Chinese medicine⁴:

regulate the qi and harmonize blood to resolve the stasis to maintain unobstructed flow of the channels and collaterals;
transform phlegm and eliminate damp;
soften the hard and dissolve nodules;
dissolve toxins and stop pain;
tonify qi and cultivate blood;
invigorate the spleen and pacify the stomach;
replenish and tonify the liver and kidneys.

The opinions of leading physicians in literature are useful to review to provide insight for the practitioner on how to apply these principles. Physician Ru Jin Zhao’s approach to the treatment of cancer lies in “adjusting the macroenvironment to adjust the microenvironment (the body).” He maintains that phlegm formation is a major mechanism in the development of cancer. Therefore, his approach is to treat the lungs to alleviate the development of substantial phlegm formation and to promote stomach yin, the lack of which contributes to phlegm formation.⁵

Zhang Dai-Zhao, author of The Treatment of Cancer by Integrated Chinese-Western Medicine ⁶ claims, “Treat the branch in acute cases and treat the root in chronic cases.” The root implies supporting the righteous qi and eliminating evil qi at the same time. For him, this means giving large quantities of herbs to tonify and benefit the qi and blood in order to promote fortification of the patient, and the administration of both Western and Chinese anti-cancerous substances to prevent recurrence and metastasis. He says, “The severity of the condition and the stage of the disease must be thoroughly understood when administering Chinese herbal ingredients. There is a saying in TCM, ‘Cracking toxins with poisons.’ The treatment of cancer in general proceeds from the principle of cracking toxins with poisons. However, if special attention is not paid to the overall condition of the patient, random cracking always results in early deterioration and death.”⁷

The warning here is that focus should be on addressing the whole person by supporting their zheng qi (true or righteous qi), even while “attacking” the cancer. A correlation is easily drawn here between the Chinese idea of “Cracking toxins with poisons” and the Western idea of chemotherapy and radiation.

Others purport that cancer, like all other diseases, is regarded as the underlying imbalance. The tumor is the uppermost branch, not the root of the illness.⁸ It is generally recognized that cancer is a local manifestation of a general ailment. Once a tumor mass exists, there will be manifestations of yin–yang disharmony.⁹

In The Practice of Chinese Medicine¹⁰, Giovanni Maciocia states, “Abdominal masses cannot be separated from that of Western diagnosis. In the case of abdominal masses perhaps more than any other, a Western diagnosis is essential. We should never treat them blindly without first establishing what they really are. This is because masses in the abdomen can be due to a number of causes, including enlarged organs, cysts, myomas, spastic colon, fecal masses, or tumors.”

In Treating Cancer with Chinese Herbs, herbalist Hong-Yen Hsu posits, “In Chinese medicine, diagnosis of tumors is made through the four methods: observing, listening, questioning, and palpating. Through these methods, the Yin or Yang, surface or inside, chill or fever, weak or firm conformations, existence, or non-existence of pus, and hence the malignancy or benignity of the cancer are noted. Then after summarizing the data, a correct judgement can be made.”¹¹

From the Chinese medical view that the causative factor comes under the heading of “toxin,” a concept that inherently implies a vigorous pathogen, which usually localizes its impact. What causes the growth to persist over a prolonged time is the alteration of normal blood circulation. The tissues are unable to return to normal because the blood can no longer help to organize the normal pattern of growth and breakdown. The treatment for the excessive growth is normalization of blood circulation and elimination of the toxin. It is often thought that the blood vitalizing is the critical factor because once the circulation is normalized there is a chance for the body to eliminate the toxin on its own.

Finally, the renowned C.S. Cheung’ treatment strategy maintains that in its early stages the can cancer is an excess, and so the excess or branch should be addressed. In the mid to latter stages, the patient presents with a combined repletion/vacuity pattern with emphasis on vacuity and so should treatment. In the later stages, characterized by further vacuity, the treatment plan should be to support the normal qi and reduce pain. He considers it critical to treat according to differentiation of the pattern, not the Western ‘type’ of cancer. He says it is important to perform tongue diagnosis to assist in the proper differentiation in order to select acupuncture and herbs for treatment.¹²

As suggested by all of these sources, it is important to be aware of the root and branch of the disease, as well as the severity of the condition, the stage of disease and location of the cancer as determined by Western diagnostic tools so as to formulate a treatment plan.

Integrated Cancer Treatment Modalities—Western and Chinese

An integrated approach to the treatment of cancer, using both Western and Chinese medicines, is a solid, rational, and recommended approach. The Western treatment truly uses an “attack” principle of treating cancer (the Chinese idea of cracking toxins with poisons), which, in turn, produces many debilitating side-effects. It is essentially in the treatment of these side-effects that Chinese medicine excels. In addition to treating the symptoms of such side-effects, Chinese herbal therapy also treats the root by supporting the zheng qi, improving immunity, and decreasing the percentage of recurrence.

Chinese Herbs in the Management of Cancer

Herbal formulas constitute the primary form of treating cancer with TCM. In China, the majority of cancer patients are treated by Western therapies, although the selection of drugs used in chemotherapy is frequently different due to approval of new compounds in China not yet used in the West. There are two basic situations, described below, where herbal therapies enter into cancer treatment.

As we have seen, the term cancer applies to a wide range of diseases, which have, as a common factor, the loss of normal cellular growth control mechanisms. Most cancers manifest symptoms of “accumulation,” described in traditional Chinese medicine terms as entanglement of qi, stasis of blood, and accumulation of phlegm. While each cancer type deserves independent study and treatment, and though each patient will have different constitutional factors that influence the specific treatment, there exist general principles of herb therapy that can be applied to most cancer patients.

Herbs that are more specific to the tumor type being treated, and in several cases qi tonics, are added to enhance immunity and benefit the weakened patient. The features of the herbal approach are described below:

Herbs can nourish the kidney and liver, and regulate the circulation of qi and blood.
Herbs can influence the hormonal system.
Chinese herbal therapy is used to make the individual healthier.
Chinese herbal therapy is used to keep estrogen at the level the body needs, which is at a moderate level. The Western medical approach is to ensure no further tumor growth by keeping estrogen low. One cannot ensure that herbs will not influence estrogen. Chinese herbs may very well be of benefit to the individual who has had an estrogen-dependent tumor. However, they should not be used in cases where estrogenic materials are strictly prohibited by the oncologist. It is therefore recommended that patients wishing to follow their oncologist’s recommendation about estrogen do not use any Chinese herbs.

Licorice (Radix Glycyrrhizae) is purported to have estrogenic activity. The main activity of licorice, in terms of hormones, is a corticosteroid-like anti-inflammatory action. Small doses of licorice (or its main active component glycyrrhizin and glycyrrhetinic acid) have been shown in laboratory animals to reduce the action of estrogen on growth of the uterus (thus antagonizing estrogen effects), but high doses (much higher than in Chinese herbal formulas) were found to potentiate the action of estrogen. These components have been shown in other studies to lower estrogenic activity when it is high and potentiate it when it is low. Thus, if anything, it is possible that licorice has a protective effect. Further, active components from licorice, such as glycyrrhetinic acid, have been shown to have anti-tumor activity.
Herbs can assist the chemotherapeutic agent in destroying the tumor. Prescriptions with a large number of ingredients in the form of an herbal decoction are provided in Chinese hospitals to address both the tumor site and the general problem of “resolving” the swelling. The use of a tumor-reducing herbal compounds becomes more important if the oncologist believes that chemotherapy alone has a limited chance of eliminating the tumor (based on statistics from previous attempts).
Anti-tumor formulas, usually adjusted to the type of cancer being treated, are also administered in the hope of causing a more rapid and complete elimination of the tumor. Studies conducted in China indicate about a 50 % increase in average survival time in cases of lung or liver tumors when herbal therapies are used. Similar prescriptions may be used in persons who do not undertake any of the Western therapies because they are deemed ineffective or undesirable for some reason. A few hospitals in China specialize in the treatment of cancer using mostly herbal therapies.
Herbs are used to counteract the side-effects of anti-cancer therapies. They are used to decrease nausea and other gastrointestinal distress or to reduce leukopenia and other blood disorders that arise. Herbs are also used to offset the immune-suppressing action of chemotherapy.

Fu Zheng Pei Ben (FZPB) is an herbal treatment currently used in China in the integrated treatment of cancer.¹³ The main principles of Fu Zheng Pei Ben are to:

prevent the formation and development of cancer;
increase immunity;
enhance the regulating functions of the endocrine and humoral systems;
protect the bone marrow and promote its hematopoietic function;
strengthen digestion and absorption and improve metabolism;
rectify deviation of yin-yang relations;
increase the effects of all therapeutic measures of Western medicine;
in addition to herbal treatments, utilizes both nutritional therapy and qi gong.

The FZPB materia medica is based on the principles of yin and yang, qi and blood. The herbal categories utilized include yin-replenishing herbs, yang-reinforcing herbs, qi-replenishing herbs, blood tonics or blood-nourishing herbs, pathogenic heat-removing herbs, polysaccharides; blood-replenishing and invigorating herbs; immunological function-enhancing herbs, and herbs for the spleen and stomach that regulate digestion and enhance assimilation of nutrients.

Among the fu zheng herbs commonly found in the West are Astragalus-based formulas, which contain immune-enhancing polysaccharides, medicinal mushroom products and ginseng-based formulas, which contain saponins that have immune-enhancing effects.¹⁴

In treating certain cancers with Chinese herbal remedies, in conjunction with chemotherapy and/or radiation, it may be important to include herbs that help raise the count of erythrocytes, leukocytes, and thrombocytes, such as Radix Pilosulae Codonopsis, Radix Rehmanniae Glutinosae, Radix Angelica Sinensis, Radix Ginseng and Radix Salviae Miltiorrhizae, among others. The components used in the formulas should contain at least one of these herbs. Check with the patient’s doctor about this strategy as it can be contraindicated for some cancers.

Surgery

Western Treatment Principle

Surgical removal of tumor.

TCM Treatment Principle—Fu Zheng Pei Ben Principle ¹⁵

Prior to the surgery, rectify the deviation of yin/yang, that is, strengthen the body for surgery. After surgery, the function of the spleen and stomach should be strengthened, the yin nourished, and body fluids promoted for post-operative symptoms of dry mouth, constipation, coughing, fever, and infection.

Chemotherapy

Western Treatment Principle

Chemotherapy is used to treat the systemic nature of metastatic neoplasms. Chemotherapy should only be used:

To effect a cure—used alone or with other modalities such as surgery and radiation.
For palliation—to afford significant relief of symptoms and, in certain cases prolong survival. The side-effects of chemotherapy are numerous and, at times, life-threatening, e.g., nausea, vomiting, weight loss, anorexia, diarrhea, abdominal pain, renal tubular damage, decreased kidney size, fibrosis, fatigue, somnolence, confusion, agitation, hallucination, headache, irritability, depression, hypersensitivity, fever, chills, sterility, menopausal symptoms, amenorrhea, alopecia, dermatitis, oral ulcerations, photosensitivity, hyperpigmentation, hemorrhagic and non-hemorrhagic cystitis, pneumonia, elevated transaminases, and hepatitis.

TCM Treatment Principle ¹⁶

Tonify and cultivate qi, invigorate the spleen and harmonize the stomach, nourish and tonify the liver and kidneys, and clear heat and dissolve toxins. FZPB therapy prevents, alleviates, and diminishes the side-effects of chemotherapy, and strengthens its actions with herbs containing polysaccharides. When there are only mild side-effects or no side-effects, TCM can be applied. If the side-effects are serious, integrated methods should be used, including blood transfusion for bone marrow inhibition and antibiotics or hormones for infection.

Radiation Therapy

Western Treatment Principle

The goal of radiation therapy is to sterilize a targeted tumor completely while preserving the integrity of surrounding normal structures. Nearly 60 % of all cancer patients undergo radiation therapy either by a beam that is directed toward the tumor area or placement of radioactive sources directly into the malignancy. Side-effects include skin toxicity; oral cavity and mandibular toxicity (decreased salivation); hematologic toxicity (injury to bone marrow, affecting blood production); and gastrointestinal toxicity (nausea, vomiting, diarrhea that commonly occur 2 to 6 hours after abdominal or pelvic irradiation).

TCM Treatment Principle ¹⁷

The side-effects of radiation mostly cause injury to the yin fluids by hot toxins, disharmony of the stomach/spleen, and vacuity and injury of the liver and kidneys. Therefore, the following treatment strategies should be considered: clear heat and remove toxins, generate fluids and moisten dryness, cool and tonify qi and blood, invigorate spleen and harmonize stomach, and nourish and tonify the liver and kidneys.

According to TCM¹⁸, ionized radiation is an aggressive material with a hot nature, which may become evil fire, consuming body fluid and essence, leading to yin vacuity and decreased body resistance. The following FZ treatment principles should also be considered: move blood in order to enhance radiotherapeutic effect by increasing blood circulation, therefore delivery of radiation to the tumor site; nourish the yin of the kidney and liver; tonify qi and nourish yin.

Immunotherapy

Western Treatment Principle

The primary goal of immunotherapy is to recruit the body’s natural defense mechanism, the immune system, to combat the malignancy. The process is to administer substances designed to provoke an anti-tumor response by the body’s own cells.

TCM Treatment Principle

Nourish the spleen and stomach, nourish the kidneys, harmonize the qi and blood, and resolve stasis.

Bone Marrow Transplantation

Western Treatment Principle

Bone marrow transplantation has been proven to be curative in cancers that were previously uniformly fatal. It affords the opportunity to exploit doses of chemotherapy and radiation that normally produce excessive hematological toxicity. Specific complications of bone marrow transplantation include the following: infection; subacute, nonbacterial interstitial pneumonia; hemorrhagic cystitis; veno-occlusive disease of the liver, pulmonary complications (obstructive lung disease); endocrine complications (infertility, hypothyroidism); secondary malignancies.

TCM Treatment Principle

Nourish the spleen and stomach, nourish the kidneys, tonify qi and nourish blood, stop bleeding, prevent stasis.

Acupuncture Strategies

An understanding of how cancer spreads has implications for treatment. The ways are summarized below again so that we can see their relationship to acupuncture strategies. Cancer spreads:

through progressive direct local invasion of nearby structures;
through body cavities;
via the blood stream (hematogenous metastasis). Most lethal cancers are this type; and
via the lymphatic system (lymphogenous metastasis).

The highest risk of metastasis probably occurs from direct contact or other strong stimuli applied on or near a tumor, especially if it is close to the skin. However, the odds of survival of the shedded cells are less than 1 %. Even so, practitioners should be aware of these routes of transmission and select treatment modalities accordingly. This would mean not massaging or palpating a tumor. Intense movement modalities and heat application should be limited or avoided. Metastatic sites should be approached with caution. While fears about increasing blood and lymph circulation are probably unfounded, the benefits and risks must be weighed, and informed consent obtained for this as well as any type of treatment.¹⁹

With its 5000-year history, Chinese medicine has become adept at recognizing the signs and symptoms of the healthy human organism. Likewise, it has developed and refined treatment modalities that redirect, cultivate and maintain proper physiological functioning. The essential Chinese treatment plan for patients who are diagnosed with cancer is to support normal cellular, tissue, and organ physiology in the wake of the ravaging and yet life-saving techniques that characterize the most common allopathic approaches to cancer—surgery, drug therapies, and radiation. Utilizing these standard treatments, augmentation with Chinese medical treatment not only relieves many of the side-effects caused by these therapies, but has also been shown clinically to strengthen the patient from the cellular through the spiritual level.

The Chinese treatment modalities most effective in the treatment of the whole person, and likewise the cancer, include as we have seen, internal and external herbal therapy. Additionally, auricular acupuncture, body acupuncture, moxibustion (a combined heat/herbal therapy) and guided imagery are recommended. Patients respond well to these treatments, many of which are simple to learn, easy to administer, and are both cost and clinically effective because they are based on the Chinese world view that recognizes the patterns of the proper flow of energy (or proper physiology and functioning).

Documented increase in white blood cell production; heightened energy; re-growth of hair; increased libido; decrease in nausea and vomiting; improvement in appetite, decreased abdominal distention, loose stools or constipation; alleviation of depression, anxiety, fear, irritability or other emotional aberrations; quicker wound-healing capacity and response to infection; decrease in skin irritation, dry skin, muscular weakness; regulation of weight loss, thirst, and pain; improvement in respiration—in short, an overall improvement in the quality of life, both in terms of physical and emotional problems and affect—these are the primary signs and symptoms with which Chinese medicine has results. A broad range of systemic clinical manifestations is addressed, but ultimately, through this style of medicine, immunity is enhanced.

Chinese medicine is time-tested, person-oriented and clinically applicable to the devastating illnesses of our time such as cancer. Although ancient, it parallels innovative Western techniques that are being developed to address this difficult disease, with its emphasis on the intimate relationship between the person and the planet, cultural stresses, nutrition and genetic inheritance.

The “secret” to its success lies in its artistry, that is, its ability to view each person as a unique constellation of energy or symptoms, not as a disease. The key to this ability to do so is because, while it certainly recognizes and can categorize and differentiate clinical manifestations into a disease pattern, it never sees the body, mind, and spirit as separate. Fundamentally, the preponderance of symptoms are viewed as rooted in spirit, and as the primary Chinese medical text the Huang Di Nei Jing (The Yellow Emperor’s Classic of Medicine) reminds us “In order to cure disease, one must first establish contact with a patient’s spirit.”

Such complementary therapies should be sought out for the benefit of each individual patient and is consonant with the general goals of the Cancer Advisory Panel on Complementary and Alternative Medicine (CAPCAM), the National Cancer Institute (NCI) and undoubtedly any physician’s deepest desires.

Over the last 25 years, I have treated cancer patients both in my private practice, as well as during a 1-year externship at a Western facility that I headed up for the students at my college. The following treatments were used successfully with those patients, not to cure them, but to assist in improving the quality of their lives while undergoing Western therapeutics. Measurement of the effectiveness of cancer treatment is usually considered successful if there is first an improved sense of well-being. Most patients reported this feeling as early as their first treatment and this was certainly the strength of the medicine we had to offer them. Within limits, increased weight gain and increased white blood cell production is usually desirable. The results of Western tests are, of course, necessary to determine cure.

Auricular Medicine

The first treatment, which I devised to treat patients and have the students use in this fast-paced Western oncology clinic, involved auriculotherapy. Due to the unique nature of this clinical setting we began with a quick, easy-to-do treatment of utilizing auricular acupuncture on these patients. This modality was selected for its non-invasiveness and its quick-acting and long-term effectiveness.

A core prescription was designed with the combined purposes of addressing both the side-effects of allopathic treatment, the nature of the illness, and the person as a whole. It was employed in numerous ways—in its essence as described here, as the skeletal outline of the treatment where points could be added or deleted, or in combination with other treatments. These points and their energetic functions are described below and in Table 6. 1. Their locations are also illustrated in Figure 6.1.

Point	Energetics
1. Shen men	Perhaps the most important point in this prescription. Shen men is used to quiet the heart, calm the spirit, and ground the patient. It puts the patient into a state of receptivity for treatment by establishing contact with the patient’s spirit. According to the ancient Su Wen text, “when the heart is serene, all pain is negligible.” Shen men regulates the blood as it pertains to the heart. It reduces insomnia, anxiety, palpitations, neurasthenia, and restlessness—common symptoms related to radiation and chemotherapy treatment. It neutralizes toxins, and cures inflammations, side-effects of Western therapy
2. Sympathetic (any of its three locations)	It decreases pain by increasing vasodilation, improves circulation, supports the sympathetic nervous system, and balances the autonomic nervous system, thereby improving overall functioning. It addresses the pain that is usually a symptom of cancer treatment therapies
3. Lung (upper or lower)	As the master of the qi, it increases energy, improves respiration, and sends its energy to the kidney to further assist in respiration. It moves the liver (metal controls wood), thus assisting in pain relief, relieves depression, strengthens wei qi (defense qi) functioning and improves oxygenation. It aids in skin problems such as decreased wound-healing capacity, and decreases dry and irritated skin caused by Western cancer therapies
4. Liver	Promotes the free-flowingness of qi, maintains the internal patency of qi, and regulates the relationship between the internal and external environment. It moves qi and blood that may be stagnant and balances the emotions. There is usually a large emotional component to cancer and its treatment. It builds yin and blood that are consumed with radiation
5. Kidney	It tonifies the root qi, the basis of our immunity. It assists in hair regrowth and increases libido—problems cancer patients can experience
6–7. Spleen and stomach	To reinforce the qi of the central burner (for nausea, vomiting; assists in digestion, improves appetite). They reduce damp/phlegm, thereby reducing thirst, and abdominal distention. They control the blood and the blood vessels. As earth points, they ground the patient, strengthen muscles and build blood
8. Brain (also known as sub-cortex)	For fatigue, anxiety, swelling, shock, etc. It regulates cerebral excitation and pain perception. Regulates all body systems and all neurological functioning. Reduces inflammation. Because it benefits the mind it can be used for insomnia and neuropsychiatric disorders accompanying the illness

Note: If needed, add or delete points based upon signs and symptoms.

Table 6.1 Ear acupuncture treatment for oncology patients

Needles and Magrain pellets were most commonly employed. For patients whose constitution was relatively stronger or for those who could not have body acupuncture (for instance, they could not lie down comfortably or a room was not available) 36 gauge ear needles in contrast to the normal 28 g used for the ear, chosen for patient comfort, were inserted in one ear to the standard depths of insertion (approximately 0.01 cun). A strong stimulus obtained by twirling was performed and the needles were retained 15 to 30 minutes. The opposite ear was then reinforced with pellets so that the patient could continue to receive the benefit of treatment.

For needle-sensitive or weakened patients, gold Magrain pellets, chosen for their tonifying effects and ease of application were affixed to the ear for 3 to 5 days. Patients were instructed to gently massage the pellets for about 3 to 5 seconds several times a day and return to the clinic or remove them if they could not come in for a treatment since the possibility of ear infection is possible in patients who already are immunocompromised. Regardless of the type of cancer, patients’ response to this method of treatment was favorable. Most reported an abatement of symptoms such as nausea and fatigue and an improvement in appetite, sleep, stools, stamina, and emotional attitude. On those on whom it worked best, patients would report they could tell the difference between having the pellets in or out of their ear. They always felt better with them in.