Thursday, September 16, 2010

Be courageous and be wise humane

TCM AND CANCER TREATMENT: BENEFITS OF AN INTEGRATED APPROACH

by Yeong Sek Yee & Khadijah Shaari
(source:www.cacare.com newsletter)
INTRODUCTION

Can East Meet West? That was the headline of an article that appeared in The Star, Sunday Feb 14, 2010. In the article, it further asked......Can Western Medicine and Traditional Chinese Medicine (TCM) join hands to treat cancer patients? Well, the answer to that question depends on who you ask.

In the article, Prof Li Fu Min, a Singapore-based consultant TCM practitioner who specialises in immunology and oncology lamented that......”sometimes patients are told to completely avoid consuming traditional Chinese medicines when they are on conventional cancer treatment”..........even though......”on the contrary, TCM can play a supportive role to cancer treatment”.

Invariably, almost all doctors/oncologists in Malaysia will advise cancer patients not to seek other treatments (whether herbal or other forms) while on their so-called”evidence-based” treatment (For that matter, they also advise cancer patients to stay away from taking anti-oxidants, etc) Their reason? It will “clash” with their “evidence-based“treatments.

In the above article in The Star, Prof Li Fu Min, further comented that:
a) An integration of both Western and TCM....is more beneficial than using any of them alone;
b) TCM can help cancer patients with their side effects and their recovery;
c) TCM can also help reduce the chances of recurrence when taken long-term

In this compilation, we reviewed 10 books written by prominent doctors/oncologists (PART 1) and we also reviewed 20 scientific studies conducted by prominent medical doctors, oncologists and cancer researchers....(PART 2).

All these 30 reviews clearly indicate that ... contrary to your doctor’s advice, (that other forms of treatment will “clash”,etc) TCM can play a very significant role in your cancer treatment.

SO READ ON AND FIND OUT FOR YOURSELF WHY AND HOW TCM CAN HELP YOU



PART 1- BOOKS BY MEDICAL DOCTORS:

1) ALTERNATIVE TREATMENT FOR CANCER edited by Dr Ping-Chung Leung of The Chinese University of Hong Kong and Dr Harry Fong of The University of Illinois, USA

In Chapter 1: “The Scientific Basis of Chinese Medicine and Cancer Care: A Western Medicine Perspective,” Dr Stephen M. Sagar and Dr Raymond Wong (both oncologists at the Departments of Oncology and Medicine at McMaster University, Canada) pointed out the benefits of combining traditional Chinese medical therapies with modern medicine…..main points are as

a) The goal of cancer treatment should be to increase patients’ survival when possible, and to improve their quality of life. TCM is able to support patients being treated with conventional Western medicine (page 10). TCM can favorably modify the tumor response to conventional Western Cancer treatment (page 11).

b) Another strategy that TCM uses in cancer therapy is to strengthen the whole body-mind system by enhancing and harmonizing the energy balance between all the organs…. improvement of the immunological function of cancer patients is associated with an improvement in their survival (page 14/15).



2) RESTORED HARMONY: AN EVIDENCE BASED APPROACH FOR INTEGRATING TRADITIONAL CHINESE MEDICINE INTO COMPLEMENTARY CANCER CARE by Dr Stephen Sagar, the oncologist who wrote the article in the book reviewed above.

In this book, Dr Sagar also stressed that:
a) TCM can play an important part in reducing side-effects of anti-cancer therapy, and contribute to the potential for a sustained quality of life, and even cure (page 16).....Chinese herbs...counteract the toxicity imposed on normal, healthy tissues, by the side effects of anti-cancer therapies (page 8)....it also strengthens the person’s natural healing resources, such as immunity, regeneration and repair.(page 8)
b) Some Chinese herbs are anti-oxidants that can mop-up an excess of free radicals ( more free radicals are induced by radiation therapy and some chemotherapy agents....page 31) allowing them to destroy cancer cells, but terminating their activity before they can damage non-cancer tissues (page 32).



3) ANCIENT HERBS, MODERN MEDICINE by Dr Glenn Miller, MD, and Dr Henry Han, OMD

The following are the main points of Chapter 12—CANCER: TREATING CANCER WITH INTEGRATIVE MEDICINE
a) What often makes chemotherapy a success or failure is how well a patient tolerates the treatment. Chinese medicine can reduce many of the side effects and make it possible for patients to tolerate higher doses of chemotherapy by sensitizing the cancer cells (page 179).
b) Herbal treatment can also enhance the therapeutic efficiency of chemotherapy and radiation therapy….. Chinese herbal medicine can support and strengthen the immune system and ….. it can also help reduce the possibility of the recurrence of cancer (page 179).
c) Strengthening the immune system is pivotal in prevention, treatment and improving the quality of the patients’ life (page 185).
d) The complementary use of Chinese herbal medicine and the Western medicine in the treatment of cancer has been extensively researched and documented in Chinese literature.(page 180)
e) The authors cited a study …”Prevention and Treatment by Chinese Medicine of the side effects due to Chemotherapy and Radiation Therapy in Cancer Treatment” by Daizhao, Zhang, and Piwen, Li and published in The Journal of Traditional Chinese Medicine (1994)……the main finding was…”patients using herbal treatment during therapy more than doubled their five-year survival rate….” The five-year survival rate tripled for the study patients who continued to receive herbal treatment for six months after chemotherapy or radiation(page 181).


4) INTEGRATIVE ONCOLOGY edited by Dr Donald Abrams, MD. Professor of Clinical Medicine at the University of California and Chief of Hematology – Oncology at San Francisco General Hospital and Dr Andrew Weil, Clinical Professor of medicine, Arizona Center for Integrative Medicine at the University of Arizona.



In the article “Traditional and Modern Chinese Medicine” (Chapter 13) by Dr Qing Cai Zhang,, MD. The author attached to The SinoMed research Institute, New York, cited various studies done on the efficacy of traditional Chinese Medicine (TCM) combined with Western Medicine (WM). Main points to note:-
a) TCM offers supportive treatments to regulate body functions to restore immunity, mitigate the side effects of WM treatments, attenuate toxicity, and enhance the therapeutic effects of WM methods. (page 262)
b) TCM can act synergistically, sensitizing originally insensitive cancer cells to WM therapies, while attenuation of toxicity can make patients more tolerant to WM treatment. (page 262)
c) TCM herbal treatment during chemotherapy mitigates side effects like toxicities to the liver, kidney, cardiovascular functions, damage to the gastrointestinal tract, etc and improves quality of life and long-term survival. Herbal treatments can also help patients better tolerate chemotherapy and complete the treatment plan (page 265).
d) The main purpose in using CM treatment for patients undergoing radiotherapy are to enhance the anticancer effects of radiation therapy, reduce its side effects, restore general health, and prevent relapse and metastasis (page 269).
e) The effects of herbal treatments were similar to the effects of antiemetic and colony-stimulating factors in mitigating the side effects of chemotherapy, but it was much less costly (page 267).
Lastly, Dr Qing also mentioned that ….. most oncologists do not want their patients to take any substance they do not prescribe – including dietary supplements – during treatment (page 259). DOES’NT IT SOUND FAMILIAR??



5) COMPREHENSIVE CANCER CARE : Integrating Alternative, Complementary & Conventional Therapies by Dr James S. Gordon, MD, a Clinical Professor of Psychiatry and Family Medicine at Georgetown University School of Medicine in Washington, D.C. He was Chairman of the White House Commission on Complementary and Alternative Medicine (CAM).


According to Dr Gordon, ...“some oncologists are already encouraging the study and use of Chinese herbs. Many, however, are still fearful of unspecified kinds of interferences between the herbs and radiation and chemotherapy ...our best reading of the Chinese literature... the best research has shown that using herbs appropriately in combination with chemotherapy and radiation significantly enhances the effectiveness of these therapies” (page 127).



6) INTEGRATING CONVENTIONAL AND CHINESE MEDICINE IN CANCER CARE: A CLINICAL GUIDE by Dr Tai Lahans, a practitioner of Oriental Medicine. She has been in private practice in Seattle, Washington for the past 20 years specialising in Oncology. She founded the only residency program in integrated oncology with Chinese medicine in the US.


In trying to integrate conventional and Chinese medicine,...there are many issues that arise when treating patients with combined care. Most of the controversy arises on the part of conventional medicine and the concern that there will be an adverse reaction between herbs and drugs, including an undermining of the effectiveness of the conventional treatment by herbal medicine or supplementation. The main issues include the concept that antioxidant-like therapies may interfere with the free-radical effect of cytotoxic therapies and the concept that some herbs may be ‘phytoestrogenic’ and proliferative in effect (page 15).


And although the idea that antioxidants scavenge free radical is intuitive and logical, the vast majority of studies into whether or not antioxidants interfere with the free radical and, therefore, cytotoxic effects of chemotherapy and radiation, report in favour of antioxidant use during conventional treatment for cancer. Over 98% of all studies show that, counter-intuitively, antioxidants enhance the free-radical effects of almost all chemotherapeutic regimens and radiation therapy (page 15). On the other hand, we (Chinese medicine) have a great deal to offer the gap of limiting harm caused by conventional treatment and, in modern China and Korea, higher dose chemotherapy is used because of the supportive care offered by combining treatment with Chinese herbal medicine. There is a vast number of highly sophisticated and well designed studies from China, Korea, and Japan that show significant efficiency for the combined medicine approach (page XIV).


Herbal medicines are used to interface with the cytotoxic mechanism and to potentiate its effects. Formulas are also used to ameliorate the side effects of conventional treatment in order to enable the patient to remain as healthy as possible and to be able to maintain the treatment schedule for the cytotoxic intervention (page 16).



7) NATURAL STRATEGIES FOR CANCER PATIENTS by Dr Russel Blaylock, MD, a broad-certified neurosurgeon with more than 20 years experience. He is the Clinical Asst. Professor of Neurosurgery at the Medical University of Mississippi .


In the section Herbal Combination in Chapter 7, Dr Blaylock cited studies that show: -
a) Patients receiving Chinese herbs had a significant improvement in their immune function and better blood flow than the control patients. In addition, the patients taking the herbs had fewer and milder side effects (page 212).
b) Some herbal combination was shown to significantly increase the ability of the immune cells to kill cancer cells (page 213).
c) Some Chinese herbal extracts could significantly inhibit the growth of both drug-resistant and drug-sensitive small-cell lung cancers (page 213).
d) Another study demonstrated the unique ability of herbal combination not only to stimulate immunity, but also to directly inhibit HIV viral replication (page 213).


8) SIMPLE CHINESE MEDICINE by Dr Aihan Kuhn, CMD, Dipl. OBT, a graduate of Human Medical University, Chang Sha, China.

Trained in both Western and Eastern healing methods, Dr Kuhn treats patients at her Holliston, Massachusetts clinic.
Chinese herbal medicine has a long history of use in treating cancer. Not only do some herbal medicines have an anticancer effect, but many herbs also enhance the immune function, an important factor in cancer healing. Through harmonized organ energy, cancer patients heal faster and the tumor gradually reduces in size and hardness, thereby removing the blockage to body parts. (page 70)
According to Dr Kuhn, cancer is curable if the mind is healthy and the Qi is flowing smoothly in the body. In contrast, cancer cannot be cured if your mind is not healthy, or if your Qi is blocked or weak.



9) BREAST CANCER: BEYOND CONVENTION edited by Dr Mary Tagliaferri, MD, L.Ac, Dr Debu Tripathy, MD, (an oncologist) and Dr Isaac Cohen, OMD, L.Ac.



In Chapter 4, Dr Isaac Cohen, OHD, One of the leading authorities in the field of cancer treatment and Traditional Chinese Medicine, wrote a feature “Chinese Medicine and Breast Cancer “ Following are the main points in the article:
a) Herbal medicine is the primary mode of treatment for breast cancer in TCM. There are specific herbs for all the various manifestation of the disease and the side effects of mainstream treatments, and they can be used in conjunction with all other treatments (page 46).

b) In China, there has been a trend in recent years to integrate conventional care with TCM treatment in an attempt to further optimise treatment outcomes; minimize the side effects of surgery, radiation, and chemotherapy, increase immune function, and extend life span (page51).
Some of the goals of TCM treatment programs include the following :
• Reducing tumor load.
• Increasing the function and activity of the immune system.
• Enhancing the regulating function of the endocrine (hormonal) system.
• Strengthening the digestion and absorption of nutrients and improving metabolism.
• Protecting the bone marrow and the generation of new blood cells.

c) Surgery and Chinese Medicine
TCM can be used to accelerate wound healing, increase peripheral blood circulation to aid the supply of nutrients and blood cell to the wounded area, aid nerve regeneration, reduce scarring, enhance the immune system, and prevent lymphedema – the swelling of the arm that can occur after the lymphatic vessels have been severed by surgery (page 54/55).

d) Chemotherapy and Chinese Medicine
Herbal prescriptions usually includes several components that... reduce side effects such as nausea and vomitting, reduce toxicities that occur as a result of the chemotherapy, such as bone marrow inhibition, immune suppression, cardiac toxicity, and modulate the immune system, prevent immune suppression, protect the organs and glands involved in the production of immune cells (page 58).

e) Radiation and Chinese Medicine
As with chemotherapy, TCM intervention aims to keep the patient comfortable, minimize side effects, and try to enhance the side effects of the radiation therapy. In order to increase the cell-killing effect of radiation and control its local side effects, one needs to increase oxygenation to cells and promote peripheral blood flow. Some Chinese herbs can inhibit the effects of radiation (page 72/73).

Several studies that looked at the combination of TCM and western therapies in early-stage breast cancer show that the 5-year survival rate is greater when the combined approach is used. The 5 year survival was 93% in the herb group compared with 32% in the other group. These studies suggest that the combined approach is superior to conventional treatment alone ( page 59).
NB: You can read an Internet version “Traditional Chinese Medicine in the Treatment of Breast Cancer” by the same authors. Visit www. cancerlynx.com/chinesemedicine.htm

10) DEFINITIVE GUIDE TO CANCER Compiled by Dr W. John Diamond, MD and Dr W. Lee Cowden, MD with Burton.

According to the authors,...”research has shown that TCM can effectively complement conventional medicine when the 2 systems are used in concert against cancer and other life-threatening diseases. In China, a combination of TCM and Western medicine has been showed to be more effective for treating liver cancer than conventional Western medicine alone” (page 802).


TCM can also reduce or minimize the toxic side effects of chemotherapy and radiation treatments of chemotherapy and radiation treatments while reinforcing their cancer-killing effects. Conventional oncologists who use herbs have been surprised to find that their patients not only suffer far less from nausea, hair loss, and depressed immunity, but also that their rate of recovery increases to an unexpected degree (page 802).



PART 2--SCIENTIFIC STUDIES



11) EFFECTIVENESS OF TRADITIONAL CHINESE MEDICINE FOR LIVER PROTECTION AND CHEMOTHERAPY COMPLETION AMONG CANCER PATIENTS. (2009). The Authors: Mei-Ling Liu, Li-Yin Chien and others from the Dept of Internal Medicine,Dept of TCM (Taipei Medical University Hospital). The study was Published in the eCAM Oxford Journal Evidence-based Complementary and Alternative Medicine, 2009.

The study examined the effectiveness of TCM for liver protection and completion of chemotherapy among patients with cancer receiving treatment.....hepato-toxicity is a common side effect of chemotherapy.
The study concluded that: -
a) TCM for patients with cancer receiving chemotherapy protected liver function during chemotherapy, as evidenced by lower blood AST and ALT... in other words, TCM could prevent liver injury during chemotherapy through its anti-oxidant function and decreasing degeneration of liver cells or fibrosis.
b) ...patients who had TCM in conjunction with chemotherapy tended toward a higher rate of chemotherapy completion than those who had chemotherapy alone. In the study, the chemotherapy completion rate was 76% for the case group and 59% for the control group(i.e. no TCM)
In summary, the authors demonstrated that...the use of TCM preparations improved liver function during chemotherapy among patients with cancer receiving chemotherapy.



12) ANTI CANCER EFFECTS OF CHINESE HERBAL MEDICINE, SCIENCE OR MYTH? The Authors: Ruan Wen-Jing, Lai Mao-De and Zhou Jian-Guang from the Dept. of Pathology and Dept. of Dermatology, School of Medicine, Zhejiang University, Hangzhou.The study was published in the Journal of Zheijiang University in NOV. 2006.

a) In this study, experiments showed that Chinese Herbal Medicine (CHM) played its anti-cancer role by inducing apoptosis, and differentiation, enhancing the immune system, inhibiting angiogenesis, reversing multidrug resistance (MDR) etc.
b) Clinical trials demonstrated that CHM could improve survival, increase tumor response, improve quality of life, or reduce chemotherapy toxicity.
c) ..when combined with chemotherapy, CHM could raise the efficacy level and lower toxic reactions.



13) IMPROVED OUTCOMES WHEN COMBINING TCM WITH WESTERN INTERVENTIONS FOR CANCER. THE AUTHOR: Dr Jake Paul Fratkin, OMD, LAC

In an article published in ACUPUNCTURE TODAY (Sept 2005 Vol 06, Issue 09), Dr Fratkin, summarized some studies from the book “Management of Cancer with Chinese Medicine” by Dr Li Peiwen, a highly respected TCM Oncologist specialist. Essentially, the combined approach shows significant improvement in the efficacy of the Western treatment. It also reduces symptoms associated with the cancer, treats the side-effects of Western interventions and enhances recovery time. Most importantly, the 5-year survival outcomes are remarkably enhanced, often prolonging life by twice the amount of time as with Western Medicine alone.
In China, where Western and traditional Chinese medical hospitals exist in separate worlds, patients are often recommended to use Chinese herbal soups from the Western medical doctors when given Western therapies for cancer.


14) SCIENTIFIC EVIDENCE ON THE SUPPORTIVE CANCER CARE WITH CHINESE MEDICINE. THE AUTHOR: - Dr William CS Cho, Dept of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong. Chinese Journal Lung Cancer, March 2010 Vol 13, NO 3.


Dr William Cho’s main remarks in the study : -
a) Up to 80% of cancer patients in the Western countries have utilized some forms of complementary and alternative medicine (CAM) to support their conventional cancer therapies.
b) Among the various forms of CAM, Traditional Chinese Medicine (TCM) is one of the few that has a well constructed theoretical framework and established treatment approaches for disease including cancer.
c) The use of TCM for the management of cancers can be traced back to the Shong Dynasty of 3,500 years ago. Over the centuries, various TCM therapeutic interventions such as herbal medicine, acupuncture, moxibustion and Qigong have been developed and employed in cancer treatment.
d) In addition to helping patients minimize the toxic side effects of chemotherapy and maximize their quality of life (QOL), integrating Chinese and Western medicine improve survival outcomes.


15) A NEW DAWN FOR THE USE OF TRADITIONAL CHINESE MEDICINE IN CANCER THERAPY. THE AUTHORS:- Dr Harendra S. Parekh, Gang Liu and Ming Q Wei from the Division of Molecular and Gene Therapies, School of Medical Science, Griffith University, Brisbane, Australia. The study was published in Molecular Cancer 2009 8:21 (www.molecular-cancer.com/content/8/1/21).

Following an extensive review of the literature, the authors described the detailed molecular basis of a proven group of TCM and highlight reported synergies when administered alongside so-called “conventional therapies” in tumour cell regulation and in bringing about homeostasis. The growing acceptance of TCM as a real adjunct therapy makes it an invaluable tool in the fight against many cancers and it holds much promise especially in cases where resistance to therapy is prevalent.


16) TRADITIONAL CHINESE MEDICINE IN CANCER CARE: PERSPECTIVES AND EXPERIENCES OF PATIENTS IN CHINA. THE AUTHORS: Prof Xu W., Towers, AD, Li Pei and Collett, JP and others (These are prominent Professors of Medicine, Oncologists, etc). European Journal of Cancer Care, 2006, 15, 397-403.

The authors conducted a qualitative study to explore the perspective and experiences of Chinese cancer patients and TCM professionals – in other words, the authors asked participants why they integrate TCM with conventional cancer treatments. Some of the reasons given were:-
a) Fear of chemotherapy damaging the vital essence. The most common reason for using TCM was to avoid or reduce the adverse effects of conventional therapy.
b) TCM was believed to be able to nourish the healthy qi (vital energy) and restore the normal pattern of health, which is crucial in defeating the disease.
c) One of the reasons and expectations in using TCM is the hope for cure, reducing tumour size and/ or preventing metastasis. Some patients believed that their primary tumour or metastatic lesion was cured by TCM
d) Another reason for patients to use TCM cancer therapy was safety. Overwhelmingly, all participants agreed that TCM does not cause any adverse effects.
e) Long-term effect is recovery – participants saw TCM as healing orientated “focusing on activating the natural reserves and re-building the resistance of body, so the effect is long-term rather than transient”. Several participants also claimed that “TCM is important for recovery since it can enhance the immune system”
f) Patients... unanimously felt that their overall quality of life and ability to function were significantly improved with TCM therapy.
g) Another big advantage of TCM was the low cost compared to conventional Western medicine.

Some other notable comments by authors of the study are:-
• TCM has been used for thousands of years in China and is currently widely practised in Chinese cancer centres.
• In China, many health caregivers and patients, aware of the limitations of conventional cancer therapy, are integrating TCM... with conventional Western medicine.


17) CHINESE MEDICINE AND BIOMODULATION IN CANCER PATIENTS. THE AUTHORS: Dr SM Sagar, MD and Dr RK Wong, MD – both are oncologists attached to the Juravinski Cancer Centre, Dept of Oncology and Medicine, McMaster University, Ontario, Canada.Annuals. Academy of Medicine, Spore 2010 Vol 39 No 2, pages 129-35).

Main comments in the study:-
a) Recent evidence suggests that many therapies from Traditional Chinese Medicine (TCM) can be effective for the supportive care of cancer patients. In TCM, herbs are used in combinations meant to enhance their benefits and simultaneously to reduce their side effects.
b) Initial clinical trials demonstrate a reduction of gastrointestinal toxicity and enhancement of the tumoricidal effect of the chemotherapy. Many pre-clinical studies are now demonstrating that specific combination of Chinese herbs can be synergistic with cytotoxic chemotherapy through both pharmacodynamic and pharmacokinetic interactions. The study was published in CURRENT ONCOLOGY VOL 15, NO 1.



18) COMPLEMENTARY AND ALTERNATIVE MEDICINE AMONG SINGAPORE CANCER PATIENTS
THE AUTHORS: - Dr Chow Wen Hann, Dr Pearly Chang, Dr Lee Soo Chin, et. al from the Dept of Haematology – Oncology and Dept of Epidemiology and Public Health, National University of Singapore.

The author’s main comments are: -
a) Worldwide, the use of Complementary and Alternative Medicine (CAM) by cancer patients is highly prevalent.
b) Singapore cancer patients show high prevalence of CAM use, high expectations regarding its effectiveness and doctors’ knowledge on CAM and many use it concurrently with chemotherapy or radiotherapy.
c) Traditional Chinese Medicine (TCM) was the most widely used form of CAM before diagnosis, followed by health supplements, and acupuncture and moxibustion. After diagnosis, TCM remained the most popular, followed by health supplements.
d) CAM was associated with higher Euro QoL Utility scores especially in Stage IV and older patients


19) THE ROLE OF TRADITIONAL CHINESE MEDICINE IN COLORECTAL CANCER TREATMENT. THE AUTHORS:
a) Dr KY Tan, Dept. of Surgery, Alexandra Hospital, Spore
b) Prof Dr Seow Choen, Mt,.Elizabeth Medical Centre, Spore
c) Dr CB Liu and Dr A.H. Chen, Zhejiang Wenzhou Medical College, Wenzhou, China.
d) Dr DJ Ding & Dr HY Jin, Nanjing Colorectal TCM Hospital, China.
Published in Techniques in Coloproctology (2008) 12: 1-6.

Main points in the study: -
a) TCM...had been used to treat colorected cancer over the last 2000 years or so...
b) TCM has been used successfully during the perioperative period to relieve intestinal obstruction, reduce postoperative ileus and reduce urinary retention after rectal surgery.
c) Good results have been reported in the treatment of the complications of chemotherapy and radiation enterocolitis. Favourable results have also been shown in the use of TCM either alone or in combination with chemotherapy to treat advanced colorectal cancer.
d) The use of TCM to invigorate the spleen, replenish ‘qi’, improve immunological function and regulate the flow of ‘qi’ and blood has been found to improve patient’s tolerance to chemotherapy.
The introductory remark in the Review is very apt: -
“In this modern age of medical advancement we cannot, as colorectal cancer surgeons, pass off TCM treatments as myths without first acquiring a proper understanding or study of them. An attempt should be made to understand the basics of TCM and the principles behind it”.
(BUT FRANKLY, WHICH DOCTOR WOULD BOTHER TO DO SO? TO THEM,ONLY THEIR DRUGS WORKS!!)


20) COHORT STUDY ON THE EFFECT OF A COMBINED TREATMENT OF TRADITIONAL CHINESE MEDICINE AND WESTERN MEDICINE ON THE RELAPSE AND METASTASIS OF 222 PATIENTS WITH STAGE II AND III COLORECTAL CANCER AFTER RADICAL OPERATION. THE AUTHORS: YANG YF, GE JZ, WU Y, XU Y, LIANG BY, LUO L, WU XW, LIU DQ, ZHANG X, SONG FX, GENG ZY. Department of Oncology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing (100091), China. Published in THE CHINESE JOURNAL OF INTEGRATIVE MEDICINE 2008 DEC; 14(4):251-6

The objective of the study was..... to evaluate the effectiveness of a comprehensive therapy of traditional Chinese medicine (TCM) in reducing the relapse and metastasis of stage II and III colorectal cancer based on conventional Western medicine (WM) therapy.
The study concluded that..... the combined therapy of TCM and WM may have great clinical value and a potential for decreasing the relapse or metastasis rate in stage II and III colorectal cancer after conventional WM therapy



21) USE OF COMPLEMENTARY AND ALTERNATIVE MEDICINE BY CHINESE WOMEN WITH BREAST CANCER. AUTHORS: Yong Cui1, Xiao-Ou Shu1 , Yutang Gao2, Wanqing Wen1, Zhi-Xian Ruan2, Fan Jin2 and Wei Zheng1
(1) Department of Medicine, Center for Health Services Research and Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, 6th floor, Medical Center East, Nashville, TN 37232-8300, USA
(2) Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China.
Breast Cancer Research and Treatment, Volume 85, Number 3 / June, 2004.

The aim of this study is to evaluate the prevalence and patterns of CAM use, particularly patients' intentions and their perceived effectiveness of using Chinese herbal medicine (CHM), as well as the relations between the herbal medicine use and demographic and clinical factors among Chinese women with breast cancer. They analyzed the data from a population-based sample of 1065 breast cancer women in urban Shanghai.


Overall, 98% of patients had used at least one form of CAM therapy after diagnosis of breast cancer. The most popular CAM modality was traditional Chinese medicine (86.7%), followed by the use of supplements (84.8%), physical exercises (65.5%), and support group attendance (16.6%). CHM was used by 86.4% of patients, while acupuncture was used only by 4.9% of patients. Treating cancer (81.5%) was the most common intentions of using CHM. Other cited intentions included enhancing the immune system (12%), preventing metastasis of cancer or managing other discomforts (7.9%), and lessening menopausal symptoms (4.7%).
The majority of patients reported that they had benefited from the use of CHM.



22) CHINESE MEDICINAL HERBS FOR THE TREATMENT OF SIDE EFFECTS FROM CHEMOTHERAPY IN BREAST CANCER. THE AUTHORS: Mingming Zhang2, Xuemei Liu3, Jing Li1, Lin He4, Debu Tripathy5

1Chinese Cochrane Centre, West China Hospital,Sichuan University, Chengdu, China. 2Chinese Cochrane Centre, Chinese EBM Centre, West China Hospital, Sichuan University, Chengdu, China. 3Chinese Journal of Evidence-Based Medicine, Chinese Cochrane Centre and West China Hospital, Chengdu, China. 4Books & Information Centre, West China Hospital, Sichuan University, Chengdu, China. 5Department of Medicine and Cancer Center, University of California at San Francisco, Dallas, Texas, USA.


The purpose of this systematic review was to evaluate the effectiveness and safety of CMH in alleviating chemotherapy-induced short term side effects for women either undergoing chemotherapy or having recently undergone chemotherapy.
The results suggest that using Chinese herbs in conjunction with chemotherapy or CHM alone may be beneficial in terms of improvement in marrow suppression and Immune sytstem, and may improve overall state of quality of life.
Citation: Zhang M, Liu X, Li J, He L, Tripathy D. Chinese medicinal herbs to treat the side-effects of chemotherapy in breast cancer patients. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: HCD004921. DOI: 10.1002/14651858.CD004921.pub2.


23) TRADITIONAL CHINESE MEDICINE (TCM) IN THE MANAGEMENT OF BREAST AND GYNAECOLOGICAL CANCER
THE AUTHOR: Dr XY Zhang, PhD, MD, Women’s Health Clinic, London, UK.

According to Dr Zhang:

a) TCM has a long history in the management of cancer (including breast and gynaecological cancer) patients. The management of cancer with TCM began more than two thousand years ago

b) TCM aims at: relieving symptoms (chronic pain, constipation, bloating, depression and anxiety, etc.), minimizing side effects caused by surgery, chemotherapy and radiation therapy (nausea, vomiting, fatigue, diarrhoea and lymphedema, etc.), improving the immune system, improving sexual function, restoring health, and most importantly, improving patients’ quality of life.

c) Chinese herbal medicine has been shown in several clinical studies to relieve symptoms related to cancer or induced by anti-cancer treatments (including chronic pain, nausea, vomitting, fatigue, etc.) and to improve the quality of life of cancer patients (Lin C et al. 1996; Liu F et al. 2003; Zhang XQ et al 1996).

d) There have been thousands of case reports showing the benefits of TCM treatment in patients with cancer including gynaecological and breast cancer. Many modern clinical and experimental research studies have further demonstrated the beneficial effects of TCM treatment in cancer care.

Website: www.womenshealthclinic.co.uk



24) EFFECT OF COMBINATION OF SYNDROME DIFFERENTIATION DEPENDING TREATMENT AND CHEMOTHERAPY ON PROGNOSTIC FACTORS IN TREATING MID-LATE PATIENTS WITH NON-SMALL CELL LUNG CANCER (NSCLC)
AUTHORS: Li LN, Liu WS, Xu K. Second Clinical Medical College, Guangzhou TCM University, Guangzhou 510120. seafle@netease.com

The objective of the study was ...... to observe the effect of combination of Syndrome Differentiation (SD) depending treatment and chemotherapy on prognostic factors in patients with non-small cell lung cancer (NSCLC).
The study concluded that...... TCM-WM treatment could prolong patients' survival period, elevate the long-term survival rate, it could be taken as one of the best comprehensive therapies for mid-late NSCLC patients who have missed the opportunity of surgical resection.
Published in PUBMED 2003 Aug; 23(8): 575-9.



25) ANALYSIS OF SHORT-TERM THERAPEUTIC EFFICACY OF INTEGRATED TRADITIONAL AND WESTERN MEDICINE IN TREATING NON-SMALL CELL LUNG CANCER AUTHORS: Zhou DH, Lin LZ, Zhou YQ. First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou (510405). zdh@oncology.org.cn IN PUBMED, US NATIONAL LIBRARY OF MEDICINE DEC; 25 (12) :1061-5...2005


The purpose of the study was to observe the short-term therapeutic efficacy of integrated traditional and Western medicine (ITWM) in treating non-small cell lung cancer (NSCLC) in III and IV phase.
The authors concluded that...... ITWM therapy showed better short-term efficacy in treating patients with NSCLC than CM or WM alone, showing the superiority of ITWM therapy. It can be adopted as an effective therapeutic program with low-toxicity.
NB: ITWM---“INTEGRATED TRADITIONAL and WESTERN MEDICINE”

26) CLINICAL EFFICACY OF TRADITIONAL CHINESE MEDICINE AS A CONCOMITANT THERAPY FOR NASOPHARYNGEAL CARCINOMA: A SYSTEMATIC REVIEW AND META-ANALYSIS
THE AUTHORS: Authors: William C. S. Choa; Hai-yong Chenb. a Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong SAR, China. b Department of Medicine, The University of Hong Kong, Hong Kong SAR, China. Published in Cancer Investigation, Volume 27, Issue 3 March 2009 , pages 334 - 344.

The purpose of this systematic review was to assess the efficacy of TCM as a concomitant therapy for NPC patients. A meta-analysis was conducted covering English- and Chinese-language studies published from 1966 to November 2007.
The study concluded that..... published studies suggest that TCM is efficacious as a concomitant therapy for NPC patients.
27) CHINESE HERBAL MEDICINE AND CHEMOTHERAPY IN THE TREATMENT OF HEPATOCELLULAR CARCINOMA: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS.
THE AUTHORS: Xiaojuan Shu, MPH ,Pine Street Foundation, San Anselmo, California.; School of Public Health, Nanjing Medical University, Nanjing, P.R. China. Michael McCulloch, LAc, MPH, Institute of Biophysics, Chinese Academy of Sciences, Beijing P.R. China.; Pine Street Foundation, 124 Pine Street, San Anselmo, CA 94960; Hang Xiao, MPH, PhD , School of Public Health, Nanjing Medical University, Nanjing, P.R. China. Michael Broffman, LAc , Pine Street Foundation, San Anselmo, California. Jin Gao, MD, PhD, Institute of Biophysics, Chinese Academy of Sciences, Beijing P.R. China. Published in Integrative Cancer Therapies, Vol. 4, No. 3, 219-229 (2005)


Hepatocellular carcinoma (HCC), one of the most common malignancies worldwide, is highly resistant to standard therapy. It is unclear whether chemotherapy, arterial embolization, or arterial chemoembolization improve survival advantage enough to justify their high toxicity. Treatment with Chinese herbal medicine has been explored, combining herbs that stimulate host immune response with those that have cytotoxic activity against HCC cells.
The authors sought to evaluate the effectiveness of Chinese herbal medicine combined with chemotherapy. The hypothesis was that Chinese herbal medicine added to chemotherapy for the treatment of HCC would improve survival and tumor response, when compared to treatment with chemotherapy alone.
The results.....twenty-six studies representing 2079 patients met the inclusion criteria. Chinese herbal medicine combined with chemotherapy, compared to chemotherapy alone, improved survival at 12 months (relative risk [RR], 1.55; 95% confidence interval [CI], 1.39-1.72;P< .000), 24 months (RR, 2.15; 95% CI, 1.75-2.64;P< .000), and 36 months (RR, 2.76; 95% CI, 1.95-3.91;P< .000). Tumor response increased (RR, 1.39; 95% CI, 1.24-1.56;P< .000).
The authors concluded that.....” these findings provide promising evidence that combining Chinese herbal medicine with chemotherapy may benefit patients with HCC.”


28) A SYSTEMIC REVIEW OF THE EFFECTIVENESS OF CHINESE HERBAL MEDICATION IN SYMPTOM MANAGEMENT AND IMPROVEMENT OF QUALITY OF LIFE IN ADULT CANCER PATIENTS.
THE AUTHORS: A. Molassiotis, B. Potrataa, K.K.F. Cheng, School of Nursing, Midwifery & Social Work, University of Manchester, University Place, Manchester M13 9PL, UK. Nethersole School of Nursing, Chinese University of Hong Kong, Hong Kong SAR, China. PUBLISHED IN THE JOURNAL OF COMPLEMENTARY THERAPIES IN MEDICINE VOLUME 17, ISSUE 2, PAGES 92-120, APRIL 2009.
The aim of this systematic review was to assess the effectiveness of Chinese medicinal herbs used concurrently with cancer treatments in terms primarily of toxicity management but also quality of life and survival in adult cancer patients. Forty-nine trials met the inclusion criteria and were reviewed according to standard processes of systematic reviews. These trials included 3992 patients.
The vast majority of the studies have shown that Chinese medicinal herbs improved treatment side effects, quality of life, and performance status, and some have provided evidence of tumour regression and increased survival. While no clinical recommendations can derive from such studies, the number of studies reporting positive results is high enough to suggest that Chinese medicinal herbs have a role in cancer care.

29) THE POTENTIAL OF A PERSON-CENTERED APPROACH IN CARING FOR PATIENTS WITH CANCER: A PERSPECTIVE FROM THE UCLA CENTER FOR EAST-WEST MEDICINE. THE AUTHORS: Ka-Kit Hui, MD Center for East-West Medicine, khui@mednet.ucla.edu Edward K. Hui, MD Center for East-West Medicine, Division of Geriatrics, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Michael Francis Johnston, PhD Center for East-West Medicine. PUBLISHED IN Integrative Cancer Therapies, Vol. 5, No. 1, 56-62 (2006).


Traditional Chinese Medicine (TCM) has been used in conjunction with conventional biomedicine in the prevention and treatment of cancer in China for several decades.
The authors concluded that..... TCM can be used adjunctively to improve quality of life and functional status during a patient’s struggle with cancer.
30) CHINESE HERBAL MEDICINE FOR CANCER PAIN. THE AUTHORS: Ling Xu, MD , Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China, Li Xing Lao, PhD, Center for Integrative Medicine, University of Maryland, Baltimore
Adeline Ge, MD , Department of Rehabilitation Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland
Shan Yu, PhD , Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China, Jie Li, PhD , Shanghai University of Traditional Chinese Medicine, Shanghai, China, Patrick J. Mansky, MD, National Center for Complementary and Alternative Medicine, National Institutes of Health, Bethesda, Maryland, manskyp@mail.nih.gov PUBLISHED IN ... Integrative Cancer Therapies, Vol. 6, No. 3, 208-234 (2007)


The purpose of this review is to summarize and evaluate the current status of clinical research on the use of Chinese herbal medicine in treating cancer pain, with emphasis on the efficacy and safety of the applications.
Various methods of traditional Chinese medicine herbal treatment for cancer pain management have been reported. Forty-one of the 115 studies reviewed were randomized controlled clinical trials, most comparing the effects of Chinese herbal medicine to conventional analgesics and the others using placebo controls.
These trials suggest that (1) Chinese medicine may be effective for cancer pain, and its effects are similar to those of Western analgesics; (2) Chinese medicine may reduce the side effects of conventional analgesics, thus enhancing cancer patients' quality of life; and (3) the various methods of application—topical, oral, and intravenous—are suitable to treat a range of pain conditions found in cancer patients.

FURTHER REFERENCES
1) EVIDENCE-BASED HERBAL THERAPY IN CANCER by Chris Teo, a paper presented at the 4th Perak Scientific & Research Meeting: Towards Harmonization between Modern and Traditioinal & Complementary Medicine, April 2006. Ipoh Hospital, Ipoh Perak.
2) BREAST CANCER: THE HERBAL OPTION by Dr Chris Teo, PhD.
3) THE ROLE OF HERBAL MEDICINE IN CANCER by Dr Chris Teo, PhD, a paper presented at a seminar on Integrative Oncology – Cancer Care Beyond Boundaries, Organised by the Dept. Of Nuclear Medicine, Radiotherapy and Oncology, USM, Kubang Kerian, 2008.
4) CANCER TREATMENT WITH FUZHENG PEI BEN PRINCIPLE by Dr Pan Hingji (summarises the experience of treating various cancers with integrated Western and Chinese Medicine.
5) EXPERIENCE IN TREATING CARCINOMA WITH TRADITIONAL CHINESE MEDICINE by Shi Lanling and Shi Peiguan (Summary of the authors’ clinical cases of various cancers treated with Chinese medicine as sole therapy)
6) A WOMEN’S GUIDE TO HEALING FROM BREAST CANCER Dr Nan Lu, OMD, L.Ac.
7) CHOICES IN HEALING--Integrating the best of Conventional & Complementary Approaches to Cancer by Dr Micheal Lerner...read chapter 19...Traditional Chinese Medicine – a favoured Adjunctive Therapy for American Cancer Patients
8) THE TREATMENT OF CANCER BY INTEGRATED CHINESE-WESTERN METHODS by Zhang Dai Zhao.
9) CHINESE HERBAL THERAPIES FOR IMMUNE DISORDERS by Subhuti Dharmananda
10) MANAGEMENT OF CANCER WITH CHINESE MEDICINE by Dr Li Pei Wen, a TCM oncology specialist.



NB: THESE NOTES, COMPILED BY YEONG SEK YEE AND KHADIJAH SHAARI, ARE MEANT TO BE STRICTLY FOR YOUR INFORMATION AND NOT MEANT TO DISSUADE YOU FROM SEEKING OTHER TREATMENTS.

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