Acupuncture and Traditional Chinese Medicine Can Benefit Those in Cancer Rehabilitation
Most cancer patients in early stages are treated with surgery, chemotherapy or radiation therapy, helping to eliminate or control the cancer. Cancer rehabilitation has typical complications.
Some patients with cancer are unable to complete their treatments due to side effects such as fatigue, shortness of breath, heart palpitations, poor appetite, vomiting, nausea, diarrhea, poor sleep, night sweats, general weakness, hair loss, and bone marrow suppression partially caused by a reduction of white blood cells, red blood cells or blood platelets. Because of the pain associated with both the cancer and these treatments, another common outcome for those suffering with the disease is drug addiction from pain medication. Regularly patients also undergo emotional problems such as stress, anxiety, depression, insomnia, and angry moods, which can affect their quality of life.
Acupuncture and Traditional Chinese Medicine are commonly used in cancer rehabilitation in China. Acupuncture was used in clinical evaluation of these side effects of chemotherapy. In a U.S. National Institutes of Health (NIH) Consensus: “There is clear evidence that needle acupuncture treatment is effective for postoperative and chemotherapy nausea and vomiting, nausea of pregnancy, and postoperative dental pain.” (-NIH November 5, 1997)
Acupuncture, Traditional Chinese Medicine and food therapy can help with many of the difficulties that patients struggling with cancer may undergo. These modalities ease the side effects of chemo/radiotherapy, and can help to balance blood chemistry. Strengthening the body may also allow the patient to finish the chemo/radiotherapy, as well as help to relieve both pain and nausea, and even improve emotional problems to restart a normal life.
Dr. Yang has been teaching Oncology of Traditional Chinese Medicine at colleges of Oriental Medicine for a number of years, and has years of clinical experience treating oncology diseases.
Endometriosis Pain
Endometriosis often occurs in women from thirty to forty years old. The main symptoms are dysmenorrhoea (painful menstruation) and non-menstruation pain. Pain regularly occurs in the lower abdomen and lumbosacral region, and may spread to the vagina, perineum, anus, and pelvis. Some patients may also experience painful sexual intercourse. Some patients have the experience of sudden abdominal pain during menstruation, accompanied by a pale or purple color in the face, cold limbs, sweating of body, nausea, vomiting, diarrhea or constipation, and fatigue, among other symptoms. Endometriosis commonly accompanies menstrual abnormalities, manifesting as a short cycle of menstruation, or cycle delay, along with a possibly increased or decreased volume of menses. Most patients exhibit mental and emotional changes due to long term cyclical dysmenorrhea, and may feel fear, stress, anxiety, depression, restlessness, irritability, insomnia and other emotional problems that relate to menstruation. Endometriosis can be a cause of infertility, and about 30-50% of endometriosis patients are also likely to suffer from infertility.
Endometriosis most commonly manifests as dysmenorrhoea (painful menstruation) and non-menstrual abdominal pain. Therefore, the goal of treatment of endometriosis is to both of relieve and prevent pain, eliminate the causes of endometriosis, and normalize menstrual abnormalities to reduce and prevent the recurrence of endometriosis pain. Hormone therapy and surgery are commonly used in Western medicine as treatments for endometriosis. Hormone therapy is effective for most women, but after long term use it can often cause side effects such as amenorrhea and menopausal syndrome in many patients, which then brings its own set of new health problems. Hormonal therapy isn’t a permanent fix for endometriosis, and it is possible to have a recurrence of symptoms after stopping use. Likewise, patients undergoing surgical therapy have a high likelihood of experiencing a recurrence of endometriosis symptoms, and this kind of surgery has a high risk of leading to infertility.
Traditional Chinese Medicine (TCM) that includes acupuncture and Chinese herbal formulas in the treatment of endometriosis was reported in 1960s, but Chinese medicine has a long history for treatment of dysmenorrhoea, which can include pain from endometriosis. Clinical research has shown that acupuncture and Chinese herbal formulas can relieve endometriosis pain and regularize menstrual abnormalities of endometriosis. These positive results usually remain longer than treatments via other modalities, even after a course of treatment has been terminated, and there are no side effects. Acupuncture and Chinese herbal formulas also have the ability to simultaneously improve other conditions related to endometriosis that the patient may suffer from, including the potential to reverse infertility.
TCM is also used to control or reduce the side effects of hormone therapy in Western medicine for treatment of endometriosis. By way of a clinical example, a 34 year old patient was diagnosed with pain from endometriosis, and began taking hormone therapy. This therapy caused amenorrhea – in her case a complete stopping of menstruation. However, for two years she would undergo regular abdominal cramping over a period of two to three days once a month. After a few months of treatment with acupuncture and Chinese herbal formulas, not only was her abdominal pain relieved, but she also restarted regular menstruation without pain. She was able, ultimately, to end her hormone therapy.
TCM treatment of endometriosis pain often employs two protocols at different stages (or conditions) of menstruation. The first protocol is to relieve pain of endometriosis during menstruation, usually used during the three days before the onset of menstruation until menstrual pain is reduced or disappears. The second protocol is to eliminate the cause of the endometriosis and prevent the pain recurrence, which is commonly used before or after menstruation. As another clinical example, a 38 year old patient reported regular abdominal pain during the first hour of menstruation, and was diagnosed with endometriosis. It was necessary for her to visit the ER for injections of pain medication. By way of treatment, we used the two protocols above, for pain reduction and pain prevention, for her symptoms. The patient reported that she did not need to visit the ER again after a few weeks of treatment with the above protocols. Her pain reduced following continued treatments until the pain disappeared after about eight months of treatment. Many other patients have also benefited from the clinical application of these two protocols. Acupuncture is usually used to quickly relieve severe pain of endometriosis during menstruation. Our clinical observation finds that acupuncture is regularly effective immediately within five to fifteen minutes in the treatment of dysmenorrhea pain, including pain from endometriosis. As a final example, a 28 year old patient presented with lower abdominal pain that had been part of her menstruation for the last 15 years, since she turned 13 years old. She has had severe pain in her lower abdomen during menstruation, a pain that often spreads to her lower back, and can be accompanied by headache, migraine, nausea, etc., to the point that she is often unable to go to work during menstruation. This menstrual pain was able to be relieved with each acupuncture treatment, including ear acupuncture.
Case 1
A 36 year old female with severe lower abdominal pain was referred to my clinic by her previous acupuncture physician. This pain had been consistently associated with her menstruation for the last twenty years. She was diagnosed with endometriosis twenty years ago. She had a history of unbearable lower abdominal cramping pain during the first hour of menstruation, that radiated to her lower back and vaginal area. Oral painkillers proved generally ineffective. It was common for her to need to be seen in the ER to receive injections of pain medications in order to relieve the abdominal pain during menstruation. Usually, by the second day of menstruation, her severe abdominal pain would gradually subside. She often had abdominal pain and lower back pain without menstruation. She had consulted several outpatient treatments but they failed to relieve her symptoms. She had also tried treatment with acupuncture and Chinese herbal formulas. These formulas and treatments had been designed to clear heat and dry dampness, and tonify her liver and kidney, but ultimately these failed to control her pain. Weekly massage and other forms of therapy have been able at times to help reduce her pain.
At her first visit, she had pain in her lower abdomen and lower back without menstruation, that radiated to pelvic and vaginal area. Sexual intercourse caused unbearable vaginal pain, and at times she had a burning sensation in her vaginal area with abnormal vaginal discharge or odor. She suffered from headaches, but did not have pain in her neck or upper back. Her first menstruation appeared at 11 years of age, and came regularly once a month with dark blood. There was often water without blood clots in the beginning of her menstruation, a moderate volume of the blood for 5 to 6 days and each cycle lasted 27 days. She suffered from occasional poor sleep, stress and nervousness that was worse during, and improved after, her monthly menstruation. Her appetite was normal. She had no acid reflux but experienced occasional gas and belching. She had one bowel movement a day, but which sometimes contained undigested food. Her urination was also normal. She often felt lassitude. From time to time she experienced alternating heat and cold in her body, with her hands and feet slightly cold to the touch. Her face looked slim and ruddy.
Examination showed tenderness and painful sensation with a slight touch or pressure as detailed below. There was obvious pain on both sides of her lower abdomen – she qualified the pain as 6-7/10 in her right lower abdomen, and 4-5 /10 in her left lower abdomen. There were painful sensations in her lower back at the L3 to S1, with a slight touch, which she placed at 4-5/10. The Ears Pressure Test showed that there was significant painful sensation to touch in the corresponding parts of her endocrine, head, neck, chest, waist, leg, shenmen, stomach and rectum – she described her level of pain with these areas as 8-9/10. Her tongue body presented medium sized, pale with red color. There was a slightly dark color on the tip of her tongue, and a white coating. Her pulse was thin, weak and wiry.
Based on Traditional Chinese Medicine, her conditions were due to yang deficiency in spleen and kidney, with cold in the meridian of liver, and stagnation of qi and blood. The treatment principle was to warm yang and tonify spleen and kidney, to warm and disperse cold from the liver meridian, and to enable the free movement of qi while invigorating blood. Acupuncture included electric acupuncture of points in DU20, Yintang, LI4 and GB20; the manual acupuncture points included SP6, ST36, ST27 and 25, RN3 4 6, UB23, KI3 and LV3. These were applied 15 minutes once a week. Auricular (ear) points included head, waist, leg and Shenmen, among others. The Chinese herbs included two formulas for her conditions. The first formula (1) included the following herbs: Huang Qi, Dang Shen, Gan Jiang, Bai Zhu, Rou Gui, Wu Zhu Yu, Xian Mao, Xian Ling Pi, Dang Gui, Chuan Xiong and Wu Yao. It was 50g power of an herb Rx for one week, to be taken orally 3 times a day, 2g per dose, and mixed with about 2 oz warm water within half hour before and after meals. This formula (1) was usually taken orally before and after menstruation. The second formula (2) included Wu Yao, Wu Zhu Yu, Gui Zhi, Zhi Shi, Xiang Fu, Sheng Jiang, Mu Xiang, Yan Hu Suo, Bai Shao Yao and Gan Cao. It was 50g power of an herb Rx for one week, to be taken orally 3 times a day, 2g per dose, and mixed with about 2 oz warm water within half hour before and after meals. It was taken orally at 3 days before menstruation until the end of teach menstruation cycle. The treatment during follow up visits modified some points of the acupuncture protocol, and herbs in the herbal formula, according to patient’s progression.
Result: After a few weeks of treatment, the patient reported that her menstruation had come the previous week with significant improvement in abdominal pain, and it had not been necessary for her to go to the ER for an injection of pain medication. Examination showed that tenderness in her lower abdomen and lower back had subsided to pain levels of 3- 4/10 and 2-3/10. Given the effectiveness, the treatment plan was to continue with the same methodology as before. During her fourth visit, she had no obvious pain in her lower abdomen or lower back during menstruation, but examination showed tenderness in her lower abdomen and lower back, pain she described as 2-4/10. The Ears Pressure Test showed that there was significant painful sensation to the touch in points, near 4-5/10. She changed the frequency of her visits to our clinic to once every 2-3 weeks, due to the inconveniences of her two hour drive. During her eighth visit, she reports she had slight abdominal bloating and gas, occasional slight pain in her left lower abdomen during menstruation, with pain in the range of 3-4/10. To her previous herbal formulas, the herbs San Leng, E Zhu, Chuan Lian Zi and Xue Jie were added to strengthen the functions of moving qi and invigorating blood to reduce pain. After about a few months of treatment, her pain disappeared on the lower abdomen and lower back during menstruation. There was no pain to the touch upon examination. The Ear Pressure Test showed her painful sensations in points had disappeared completely. However, her feet were still not warm, she had a slight bloating in her abdomen and reported undigested food her stool. The plan of acupuncture treatment same as before, and her previous herbal formula was modified to strengthen her spleen and help her digestion. After one year, she reported there was no pain in her lower abdomen and back, no visible undigested food stool. Sexual intercourse had again become feasible with only a slight discomfort.
Case 2
A thirty-two year old female visited my clinic to seek help for pain resulting from her abdominal distension. The patient’s abdominal pain during menstruation had been going on for six years, and she was taking oral pain medication to relieve it. She had seen a gynecologist two years previously, and been diagnosed with endometriosis. She was prescribed birth control pills to stop menstruation in order to relieve her abdominal pain. Her menstruation stopped with birth control pills two years ago, but she often had abdominal fullness, and once a month she experienced pain or aching in her abdomen for 2 to 3 days that felt similar to menstrual cramps.
When she visited me, she complained of bloating and fullness in her lower abdomen, lassitude, dizziness, chills and coldness of body. She also had occasional headaches, weakness of her legs, anorexia, some nausea without vomiting but no significant acid reflux. Her bowel movements were once a day and sometimes soft, but were not diarrhea. She had frequent urination with little volume. She had anxiety, but it did not interrupt normal sleep. Her first menstruation appeared at the age of 12, regularly came once a month for five days during a 25 day cycle, and generally had a moderate volume of bleeding, with black blood containing clots. She had lower abdominal pain that appeared the three days before the onset of menstruation, and it got worse during the first day of menstruation. Her last menstruation had been two years ago.
Examination showed that there were acne pimples and small scar spots on her face, a slightly dark color under the lower eyelids, and emaciation of her body. Her tongue body was of medium size with a pale red color, and a small crack line in the center of her tongue; there were small purple spots on the tip of her tongue which had a thin white coating. Her pulse was thin, bowstring, and especially weak in the proximal positions. There was tightness and a painful sensation in her lower abdomen with slight touch, producing pain she described as 4-5/10. There was no tenderness or painful sensation in her neck, upper back or waist with slight touch. There was coldness in her lower limbs from her knees to her ankles and feet, coldness in her upper limbs from wrists to palms and fingers. The Ears Pressure Test showed that there was significant painful sensation with touch on the corresponding parts of the brain, endocrine, neck, chest, waist and abdomen points, all with a pain level of 5-7/10.
Based on Traditional Chinese Medicine, her condition was yang deficiency in spleen and kidney, qi stagnation with blood stasis. The treatment principle was to warm and tonify yang in spleen and kidney, and to move the qi and invigorate the blood to dispel stasis. The acupuncture points included ST25, ST27, ST36, SP6, LI4, RN12, 6, DU20, Yintang. There were applied 15 minutes twice a week with acupuncture retreatment. The Ear points included head, endocrine, uterine and Shenmen. The Chinese herbal formula included herbs of Huang Qi, Dang Shen, Bai Zhu, Gan Jiang, Gui Zhi, Dang Gui, Chuan Xiong, Pu Huang, Yan Hu Suo, Xian Mao, Xian Ling Pi and Tu Si Zi; and Wu Yao, Bing Lang, and Yi Mu Cao were added for the pain and fullness in her lower abdomen. It was 50g power of an herb Rx for one week, to be taken orally 3 times a day, 2g per dose, and mixed with about 2 oz warm water within half hour before and after meals. Subsequently, the treatment during follow up visits modified some points of the acupuncture protocol, and herbs in the herbal formula as she progressed.
Results: The patient reported after a few weeks of the treatment that the symptoms of her abdominal fullness, headache and lassitude were improved. After a few weeks of the treatment there was no pain or aching in her lower abdomen. After a few months of treatment, her menstruation appeared for three days without obvious abdominal pain. Therefore the acupuncture treatment plan was changed to once a week and continued to utilize the same acupuncture protocol and Chinese herbal formula. After a few months of treatment, her menstruation was regular without obvious discomfort, and she stopped taking birth control pills. She changed the regularity of her acupuncture treatments to once every 2-3 weeks, while continuing to take Chinese herbal formula for three months – during this time she experienced no significant menstruation pain. One and half years after she ultimately stopped treatment, she had regular menstruation without symptoms of dysmenorrhea.
Case 3
A twenty-eight year old female who had severe abdominal pain during menstruation for fifteen years came to the clinic for acupuncture treatment. She was willing to come because her father’s health problems had been improved after treatment of acupuncture with Chinese herbal formula. She had once experienced acupuncture treatment 10 years previously, but due to a fear of needles, did not continue the treatment. She had been in poor health since childhood, and at eight years old she was taken to her physician with a small cyst on her abdomen and abdominal pain. She had been diagnosed with endometriosis at the age of 15.
Her first menstruation occurred at 13 years old, and thereafter it came irregularly once every 9-12 weeks for 4-5 days for each cycle, with a moderate volume of bleeding, and dark colored blood with clots. At 15 she had lower abdominal pain to the both sides of her lower back, exacerbated by menstruation. Usually her pain started 3-4 days before menstruation, got worse at the beginning of menstruation, and finally began to reduce at about the third day of menstruation. She often refused pressure on her lower abdomen and lower back during menstruation, because she felt that local muscle tension and stiffness was similar to a mass. The muscle tension and stiffness in her lower abdomen and lower back disappeared at end of menstruation. She had to take oral analgesics and rest to relieve the pain during menstruation. Her most recent menstruation had been eight weeks ago.
When she first visited, she complained of lower abdominal pain on both sides of her lower abdomen particularly, as well as lower back pain. She had refused any pressure on her abdomen and lower back. She had stress and anxiety, but normal sleep and was not depressed. She had frequent frontal headaches, sometimes as often as 3-4 times a week up to once a day. The headaches would last for hours, sometimes spreading into the next day. Her headaches would intensify at every menstruation. She was also at times fatigued and exhausted, and reported dizziness, chills, and coldness of body. She had poor appetite, desired salty food, had bloating in her abdomen with occasional nausea and vomiting, but with no acid reflux. She would occasionally have belching or gas, her bowel movements came once a day, and her urination and libido were normal.
The patient was slim and small, her voice was lower, and her facial expression was tense, but her personality was cheerful. Examination showed her tongue body was small sized, with a pale color and thin white coating. Her pulse was weak and thin. The Ears Pressure Test showed there was significant painful sensation with slight touch on the corresponding parts of endocrine, brain, neck, chest, waist, leg, Shenmen, stomach, intestine, and uterus, among others, with pain reported to be near 8-9/10. There was sweating in her palms without warmth of her hands and feet. There was a painful sensation with slight touch at the temple of her head, that she described as 3-4/10. There was a painful sensation with slight touch on her face, also 3-4/10. There was no tenderness on the her neck, shoulders and upper back. There was painful sensation with slight touch on the her lower back, with pain that she described as 5-6/10. There was a painful sensation in her lower abdomen with slight touch, where she rejected pressure, describing the pain on the left side as 6-7/10, and the right side as 7-8/10. She had no upper abdominal pain with slight touch.
Based on Traditional Chinese Medicine, her conditions were yang deficiency in spleen and kidney, and qi stagnation with blood stasis, as well as shen disorders. The treatment principle used was to tonify yang in spleen and kidney, warm meridians while dispelling cold, invigorate blood to dispel stasis, to move qi, and to calm shen to help with her anxiety and stress. Based on her sensitivity to needle sensation, slight acupuncture manipulation were used. Acupuncture points included ST36 and ST27, RN12 and RN6, LI 4, DU20, KI3, LV3 and Yintang. These were applied 15 minutes once a week with acupuncture treatment. The Ear points included Brain, Endocrine, Shenmen and Back, etc. Chinese herbal formula of herbs included Huang Qi, Dang Shen, Dang Gui, Chuan Xiong, Yan Hu Suo, Wu Yao, Bing Leng, San Leng, E Zhu, Pu Huang, Gui Zhi, Sheng Jiang, Xian Mao, Xian Ling Pi and Tu Si Zi. It was 50g power of an herb Rx for one week, to be taken orally 3 times a day, 2g per dose, mixed with about 2 to 3 oz warm water. Subsequently, the treatment during follow up visits modified some points of the acupuncture protocol, and herbs in the herbal formula, as she progressed.
Results: After her first acupuncture treatment, she reported that her abdominal pain had improved. After a few weeks of treatment, she reported that the pain was much improved in her lower abdomen, lower back and head. After five weeks of treatment, she said that menstruation appeared for five days without obvious abdominal pain or back pain – she had only lassitude and a slight headache a few hours during the day before menstruation. Upon examination it was found that her pain was greatly reduced in her abdomen, pain with slight touch around 2-3/10, and pain in the lower back was similarly 2-3/10. The Ears Pressure Test showed that painful sensation was reduced in most points, which she described as 2-3/10. After a few months of treatment, her headache, abdominal pain and low back pain were not obvious, and her menstruation had changed to once every five weeks, lasting for 5 to 6 days for each cycle, with moderate volume of bleeding, and pale red colored blood without clots. After a few months of treatment, she reported her menstruation occurred regularly once every 5 week without pain, and her stress and anxiety were much improved during menstruation. She continues acupuncture treatment once every 2 to 3 weeks while taking Chinese herbal formula to maintain her health. She and her parents were very grateful because the treatment had completely changed her quality of life.