Cancer is a hot topic that we hear about almost daily and a topic of concern for a lot of people. It is estimated that there will be 269,300 new cases of cancer and 75,500 deaths from this disease in Canada in 2013. (1)

However, from the therapeutic point of view, it is better to conceive of cancer not as a disease, but as a family of diseases. Although having some common characteristics, each type of cancer is different, with its own manifestations and specific treatments. Talking about cancer is like talking about a group of very different diseases and it can not be done accurately without looking at each particular type of cancer.

In this short article, I will discuss cancer from the point of view of Chinese medicine first by drawing a picture of the concept of cancer according to Chinese medicine, then by going into the specific case of colorectal cancer.

From the point of view of modern Western medicine, the majority of cancer cases are due to DNA damage that affects the mechanisms of growth control, maturation and cell death. These changes are more likely to occur in people with some genetic predisposition or some viral infections. The main cause is often exposure to carcinogens, in conjunction with the failure of the immune system to eliminate cancer cells in their early stages of development. Modern medicine classifies cancers according to the type of cells involved.

In Chinese medicine, cancers are classified according to the symptomatology. Common to many cancers, the tumor (liu – 瘤) has been observed and classified since the Shang Dynasty (16th to 11th centuries BC).

Any tumor stems from stagnation. Stagnation can develop from different mechanisms, including the accumulation of moisture-phlegm, external pathogens which organ deficiency (Zangfu) allows to penetrate and persist, and excess of the emotions. It is important to emphasize that not all tumors are cancerous. Cancer (ai – 癌) is an evolution of the tumor (liu – 瘤).

Traditionally, treatment in Chinese medicine mainly used surgery and pharmacopoeia, with the prescription of often radical lifestyle changes. The therapeutic orientation is mainly to evacuate toxins, dissolve accumulations, restore normal circulation and promote the healthy function of internal organs.

THE ROLE OF ACUPUNCTURE:
The role of acupuncture is mainly in the management of cancer symptoms and side effects of modern treatments such as surgery, chemotherapy and radiotherapy. Acupuncture also plays an important role in cancer remission and prevention of recurrence.

COLO-RECTAL CANCER:
The colon, in Chinese medicine, is a Fu organ that acts as a conduit for the transfer of nutrition from outside. Like the lungs, its associated organ, it is exposed and vulnerable to external influences. Among its functions, there are aspects related to the Spleen system – the functions of refinement and separation of pure and impure, and protection through the gastrointestinal mucosa (in conjunction with the Triple Warmer system).
In the development of colorectal cancer, two determining factors can be identified: Damp-Heat and Wind. Damp-heat originates from a deficiency of the transport and transformation functions of the Spleen, which can come from a weakness of the spleen and stomach, or from a diet rich in unsaturated fats, sugars, refined foods or other inappropriate foods or a diet of poor quality. The intestinal wind (Changfeng – 肠 风) refers to the accumulation of toxic heat in the intestines where it turns into toxins. The latter may be an external pathogen that enters the body via food and drink, or develops internally due to an imbalance of Zangfu. Like the Lungs, the colon produces mucus (through epithelial tissue, which is under the governance of the Spleen and San Jiao) and different forms of mucus build-up in response to pathogenic factors. Under certain conditions, these accumulations can evolve into a tumor and possibly into cancer.
Colo-rectal cancer therefore originates from an internal injury, either by dysfunction of the digestive system or by an external pathogen (Changfeng). A toxic environment (Zangdu – 脏 毒 and / or Changfeng – 肠 风) brings the malignancy of the cancer. In this context, Du (毒) refers to all expressions of toxic heat, heat-moisture and latent pathogenic factors. These toxins can therefore be exogenous or endogenous. Therefore, Changfeng and Zangdu can be considered as underlying elements of colorectal cancer. Changfeng may be associated with the early stages of cancer whereas Changdu would rather be a subsequent manifestation with metastases.

THE ROLE OF THE SPLEEN:
The spleen, which is at the center of the digestive system, can be injured by an inappropriate diet, but also by excess of emotions. An inappropriate diet is defined not only by the quality of the food ingested, but also by support and development, and consistency, rhythm and regularity. Anorexia, bulimia, irregular or immoderate eating are particularly harmful for the Middle Burner. The excess of emotions can come from unresolved emotional problems, from excessive thought and worry or from excessive repressed anger leading to a transverse attack of Wood on the Earth. These excesses can lead to transverse attack and / or deficiency of the Spleen. Over time, deficiency of Yang in the Spleen and Kidneys may appear, or heat build-up in the intestines resulting from the accumulation of moisture and phlegm or a deficiency of Qi and Blood that result possibly in a stasis of Qi and Blood. The obstruction of Qi and Blood by Wind, Wind-heat, Damp-heat or Phlegm damages Yin collaterals which can cause Blood to flow into the intestines. This flow of blood causes the presence of blood in the stool which is the main symptom of colorectal cancer.

CLASSIFICATION OF SYNDROMES:
Once the diagnosis of colorectal cancer is established, five pathological patterns can be distinguished:
1. Damp-Heat of the Intestine
2. Accumulation of toxins
3. Intestinal wind (Wind-Fire or Changfeng) that burns and damages the Large Intestine
4. Yang Deficiency of Spleen and Kidneys
5. Yin Deficiency of Kidneys and Liver
6. Deficiency of Qi and Blood.
Some authors also identify the patterns of Stomach Fire and Liver Fire that invade the Stomach.

TREATMENT :
Considering the very nature of cancer, it is important to treat it with conventional medicine. Treatment in Chinese medicine will then consist in treating the person globally in order to support conventional treatments and prevent the recurrence of cancer. Treatments should begin as soon as possible and continue throughout the course of conventional treatments.

Post-surgery treatment:
After abdominal surgery, and especially on the intestine, it is common to see a cessation of peristalsis. The recovery of intestinal function is important and the therapeutic orientation will be, in this case, to rectify the circulation of Qi, nourish the blood, stop bleeding, improve appetite and warm the lower burner.

Chemotherapy treatment:
The type of damage caused by chemotherapy is defined by the symptoms that occur. Spleen and kidney damage (blood production), Qi of the stomach (cold nature of the medication), the heart-kidney axis or yin of the liver and kidneys are particularly common. The choice of treatment will depend on the pathological patterns displayed in the patient.

Treatment with radiation therapy:
Radiation therapy burns tissue and scars result. Scars and adhesions are considered in Chinese medicine as stasis of blood. In the longer term, it can lead to deficiency of Yin, Qi and Weiqi. In the case of colon radiation, diarrhea is the main manifestation of radiation injury. We also find lower abdominal pain, irregular bowel movements, urinary dysfunction and disturbances of the menstrual cycle. In addition to treating the symptoms, herbal formulas that nourish Yin are useful.

Treatment in prevention / remission:
After the conventional treatments, when in remission, the patient will have a regular follow-up in order to control the different markers of cancer. The majority of recurrences occur within two years of completing treatments. It is only after a period of five years without illness that the majority of cancers are considered cured. Although this period is extremely important, Western medicine does not offer preventive treatments. The role of the acupuncturist is important at this stage. He can offer treatments in acupuncture and pharmacopoeia, health advice according to the risk factors and the patient’s constitution. Emotional factors should be dealt with promptly so that they do not lead to longer-term stagnation as well as the smooth promote the circulation of Qi and Blood.

REFERENCES :
1. Website of the Canadian Cancer Society. www.cancer.ca.
2. Lahans, Tai, Integrating Conventional and Chinese Medicine in Cancer Care – a Clinical Guide, Elsevier, 2007.
3. Li, Peiwen, Management of Cancer with Chinese Medicine, Dominica Publishing, 2003.
4. Dharmananda, Subhuti, Oriental Perspectives on Cancer and its Treatment,
www.timonline.org/arts/cancer.htm.
5. Sloan Kettering Memorial Cancer Center, Acupuncture for the Cancer Patient (lecture notes),
2012.
6. Sionneau, Philippe, Diseases and symptoms in Chinese medicine -Volume 7, Guy Trédaniel
Publisher, 2004
7. Jarrett, Lonnie, Nourishing Destiny, Spirit Path Press, 1998.
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(1) Canadian Cancer Society
(2) The character liu 瘤 consists of 留 (liú), to remain, to stay, and the radical of the pathology 疒
(3) Li Peiwen, Management of Cancer with Chinese Medicine, Donica Publishing, 2003.

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