Cancer Supportive Therapy

Cancer Supportive Therapy

A cancer/tumor means an uncontrollable cell proliferation (growth) occurs in one or more parts of one’s body. Timely diagnosis and early surgery offer the most favorable possibility of a cure for solid tumors. However, if the diagnosis is late, surgery unsuccessful, or should the tumor recur after surgery, then the chance of a cure, with rare exceptions, is considered lost. This class of patients, along with those not amenable to surgical approaches, is often treated palliatively with chemotherapy and/or radiation therapy. Sometimes, even if someone is lucky enough to have early diagnosis and surgery, chemo- and/or radiotherapy may also be used to suppress any potential recurrence that might arise from incomplete removal of tumor tissues or metastasis undetectable at the time of surgery.

How does chemo-radiotherapy work?

The way chemo-radiotherapy works is to interrupt DNA synthesis, an essential step for all cell types to proliferate. Since many normal cells in the body regenerate (proliferate) regularly, it is not hard to understand that while chemo-radiotherapy treatments are destructing tumor cell growth they also strongly suppress normal cell regeneration. This suppression is especially strong for those cell populations with fast proliferating rate but relatively short life span, such as blood cells.

How do side effects of chemo-radiotherapy influence the treatment outcomes?

Chemo-radiotherapy is as far known as the medication that causes the most sever adverse effects. These may include neutropenia (white blood cell reduction), anemia (red blood cell reduction), fatigue, gastrointestinal reactions (including anorexia, or the lack of appetite, nausea, vomiting, diarrhea, abdominal pain and gastrointestinal bleeding) dyspnoea and edema, hepatic failure, fever, arthralgias, myalgias and bone pain, alopecia (hair loss), etc.  White blood cells consist of main immune effecter cells, and are not only the first line of defense to fight infections but also the major intrinsic means to detect and destroy abnormal (i.e., tumor) cells. Red blood cells are responsible for providing life-depending oxygen for all tissues. Gastrointestinal reactions can dramatically affect your nutritional status. Therefore, in addition to compromising the quality of life, depending on the severity, many of these adverse effects themselves could post life-threatening risks as the tumor does. In another word, given that sufficient (dose/time) chemo-radiotherapy can theoretically defeat a cancer/tumor, tolerance of individual patient to a proper chemo-radiotherapy is the most critical factor that determines not only the quality of life but also the treatment outcomes (survival) on a cancer/tumor. That is to say, if adverse effects of chemo-radiotherapy can be minimized or one can be strengthened enough to tolerant all necessary cycles of high dose chemo-radiotherapy, one’s quality of life and survival rate of a cancer/tumor will be maximized.

How to minimize the adverse effects of chemo-radiotherapy?

Increasing number of cancer supportive care is available to minimize the adverse effects of chemo-radiotherapy. Detailed advantages versa their disadvantages follow:
☯    Western medicine: A number of drugs have been developed to combat the common adverse effects of chemo-radiotherapy. For examples, certain hematopoietic growth factors may be used to treat neutropenia; nutritional supplements and/or blood transfusions can be used to alleviate anemia; antiemetic medications are often used to treat nausea/vomiting, etc. Regardless the efficacies of these medications, however, not only some patients may not be suitable to take such medications, many of these medications themselves also produce additional adverse effects, such as bone pain by hematopoietic growth factors, drowsy and motor balance problems by antiemetics, etc. Therefore, effects of practical use of these medications are far away from satisfaction.
☯    Traditional Chinese Medicine (TCM):
TCM is a standard health care system in parallel with Western medicine in China. Over 90% cancer patients in China had received at least one form of TCM treatments including acupuncture, Chinese herbal medicine, or Qigong, etc. (for detailed information about TCM treatment forms and how they work, please refer to our AcuFlyer issues 1 & 2). Collective literature information indicates that an integrative cancer care system, which is based on diagnosis, surgery and chemo-radiotherapy relying on Western medicine in combination with supportive care (including strengthening immunity and energy, alleviating/eliminating surgery/cancer pains and other adverse effects associated with chemo-radiotherapy) depending on TCM, provides significantly better treatment outcomes (both quality of life and survival length) than only use either TCM or Western medicine alone. With more and more well-controlled studies published about the promising roles of acupuncture and Chinese herbs in cancer supportive care, the World Health Organization (WHO), the National Institute of Health (NIH) and American Cancer Society (ACS) now have all recommended to use acupuncture and Chinese herbs in cancer supportive care.

Compare to Western medicine, TCM has its privilege in cancer supportive care. First, rather than treat different symptoms as isolated problems, TCM treats a patient as a whole. For example, rather than simply inhibiting vomiting nerve center to prevent nausea and vomiting or using blood transfusion to treat anemia, TCM emphasizes reversing imbalance amongst different organs and enhancing internal organ functions. By doing so, it strengthens patient’s overall health conditions and immunity, thus patient not only feels better but also becomes stronger to tolerant higher dose or more cycles of chemo-radiotherapy if necessary. Moreover, TCM has accumulated a great deal of experience in managing pain, nausea, fatigue, and etc. symptoms by using either acupuncture or Chinese herbs or in combination. Furthermore, it is well known that there are very little adverse effects associated with acupuncture. In addition, although Chinese herbal remedies are less purified thus require relatively large dose, they are composed of multiple herbs that some will attack the primary and secondary problems and some will integrate other herbs to function better together and reduce their side effects. Therefore, unlike most Western medications and the over counter herbal/botanic extracts that each often plays a single isolated role, Chinese herbal remedies often have better efficacies and much less adverse effects.

Of course, TCM also faces many challenges, particularly at the Midwest area. In China, there are millions TCM doctors who have been educated in specialized colleges systematically for at least 5 years with the native language that all the original TCM literatures were written in. Although TCM, especially acupuncture, has received increasing attentions in the US recently, due to lack of well-trained qualified TCM doctors, the application scope and efficacy of acupuncture and Chinese herbs have been largely limited. Even at current practice level, many hospitals in both coasts have integrated acupuncture and/or Chinese herbs into their standard cancer supportive care program, while in the Midwest area, unfortunately, such an excellent cancer supportive care system is very much underdeveloped. Part of the reasons may attribute to the facts that there is significant less awareness about potential benefits of TCM/acupuncture therefore less demanding and less health insurance companies care to cover the costs in the Midwest area compared to both coasts. This might be why while many cancer patients are struggling to find a better care, significant number of them either does not know TCM/acupuncture at all or has very little knowledge for their value in cancer care.

As a TCM practitioner, every time when I see the drastic improvement after TCM treatments, at the same time while I am feeling a bit relieved, I can not help thinking that many other cancer patients are still suffering and struggling out there. Therefore, I wrote this brief introduction with the hope that this message will reach you one way or another…