Holistic Elements in Cancer Care
Being diagnosed with cancer is a shocking and frightening experience. The process of treatment can be destabilizing in every aspect of daily life. Today, Complementary and Alternative Medicine (CAM) is being combined with western medical treatment as a multimodal approach to cancer care. This is leading to a stronger network of support for cancer patients, adding a holistic element to their treatment plan that encompasses the physical, emotional and spiritual elements that are essential for health and well-being.
Acupuncture and Traditional Chinese Medicine (TCM), part of the CAM movement, treats and helps manage side effects during and after cancer treatment, and chronic conditions that remain afterward. Acupuncture is also being considered as a non-pharmacologic pain management option for people with cancer receiving chemotherapy, radiation therapy, and surgery.
A Harsh Reality
According to the National Cancer Institute, approximately 38.4% of men and women will be diagnosed with cancer at some point during their lifetimes. In 2016, there was an estimated 15.5 million cancer survivors in the United States. The number of cancer survivors is expected to escalate to 20.3 million by 2026. This increase of cancer in our population is concerning. Finding ways to lessen the impact of cancer treatment procedures and helping to strengthen survivors will ensure that those affected by this ravaging disease will have the best opportunity for a healthy future.
The most common cancers are breast cancer, lung and bronchus cancer, prostate cancer, colon and rectum cancer, melanoma of the skin, bladder cancer, non-Hodgkin lymphoma, kidney and renal pelvis cancer, endometrial cancer, leukemia, pancreatic cancer, thyroid cancer, and liver cancer.
What are the Side Effects of Cancer Treatments?
Chemotherapy, radiation and surgery are the most common procedures that are included in cancer care. While a means to fight and overcome this disease, they take their toll on the body – often causing debilitating side effects.
The side effects of chemotherapy and radiation may include:
- Dry mouth, mouth, gum, and throat sores
- Nausea and vomiting
- Constipation or diarrhea
- Skin rashes/dry skin
- Flu-like symptoms
- Weight changes
- Hair loss
- Neutropenia – low WBC’s
- Shortness of breath
- Lymphedema- swelling of limbs
- Peripheral neuropathy
- Menopause, infertility, changes in menstruation
Pain: A Challenging Side Effect of Cancer Treatment
Pain is a long-standing and unresolved clinical issue among cancer patients. It has been over 20 years since the World Health Organization (WHO) published its recommendation of an analgesic ladder for pain control. Today, 55% of cancer patients still suffer from various forms of physical suffering that significantly impacts their quality of life.
Identification of non-opioid options for pain management is a public health priority. Opioid medications, often referred to as narcotics, are the most commonly prescribed means of pain control for cancer patients. Patients are often resistant to start drug therapy due to warranted concerns about side effects and addiction.
The inappropriate use of these medications has become a real issue, now an epidemic that is leading many people to look for more natural alternatives. Acupuncture is being offered as a key participant on the ladder for pain control with positive results.
Acupuncture for the treatment of pain in cancer care has been a focus of study in the scientific community. Several randomized control trials that studied acupuncture for pain following surgical procedures found that acupuncture reduced the need for narcotic drugs such as morphine, pirinitramide, and alfentanil – the same drugs used to treat cancer-related pain.
In the field of cancer-specific pain management, randomized controlled clinical trials have suggested that acupuncture can be useful to relieve and limit discomfort for cancer patients. These trials have included patients who suffer from chronic neuropathic pain, post-thoracotomy pain with operable non-small cell lung carcinoma, and post-operative pain with breast, bladder, prostate, and ovarian cancer.
A recent National Cancer Institute (NCI) symposium on acupuncture highlighted the clinical evidence for its use in oncology symptom management. They stated that acupuncture is one of the nonpharmacologic interventions associated with fewer side effects and should be included in a multi-modal approach when managing pain.
How Does Acupuncture Treats Cancer-Related Pain?
In treating pain, scientific studies have shown that inserting an acupuncture needle causes a micro injury at the site of insertion, which stimulates the nerves in tissues of that location. This causes a release of neuropeptides, which are small protein-like molecules that are used by neurons to communicate with each other. These are essentially chemical signals to the brain. The response to this signaling is widening and relaxing of blood vessels, also known as vasodilation, which increases blood flow into that area.
This reaction to acupuncture is also called axon reflex – when the peripheral nerves of the body are stimulated and then send a response away from the site of the original nerve cell body. This electrical messaging heads into target organs as a single or multiple signaling into the nervous system. The flushed coloring or redness, also known as hyperemia, that is seen at the site of needling is also a sign of this axon reflex. It shows both an increase in nerve activity and blood flow. In Chinese medicine we call this getting the “de qi.”
Qi and blood stagnation is one of the main diagnosis associated with the feeling of pain. It describes a situation where a lack of blood movement and perfusion of oxygen into the tissues leads to dull or sharp pain, and ache. Increasing blood flow and nervous system activity with acupuncture can be equated with moving the qi and blood, relieving the stagnation in these areas.
Pain relief from acupuncture may also occur by the release of encephalin, which are neurotransmitters or neuromodulators and have opiate like effects. They are located in the brain, the grey matter of the spinal cord along with the gastro-intestinal tract.
When a signal into the central nervous system, caused by needle insertion, connects with the terminals that house encephalin neuromodulators, they are released and act as natural pain killers. They fulfill this purpose by depressing neurons throughout the central nervous system and inhibiting the conduction along what is called the nociceptive pathway. The pathway starts with the neurological response to a stimulus, or in this case injury or trauma. This transforms into an electrical event in the neurons and is then processed as a release of neurotransmitter molecules at the synapses.
This suppression of the neurons throughout the central nervous system significantly reduces physical distress, and changes how the nervous system responds to trauma.
Acupuncture isn’t just helpful in treating pain. Many patients receiving radiation for neck and head cancer suffer from xerostomia, or dry mouth. Acupuncture can be effective in generating fluids in the mouth and throat to relieve this symptom.
Studies using a functional MRI (fMRI) have found a relationship between stimulating the acupuncture point LI-2 (Large Intestine 2), located at the base of index finger, and the activation of the brain function area responsible for salivary production.
In TCM we use other acupuncture points as well, such as Kidney 6 (KI 6) to generate fluids in the throat for patients who suffer from xerostomia, especially at night. Conception Vessel 22 (CV 22) is also used to focus nervous system response, or qi, to the area in the case of a dry or sore throat. These are just a few points that address this issue and are good examples of how acupuncture can be tailored to your needs during your own journey of cancer care.
Chemotherapy-Induced Nausea and Vomiting
When chemotherapy enters the body, sensors in the digestive system and brain detect its presence as a foreign substance. A series of signals in the brain, mouth, stomach, and small intestine stimulate the “vomiting center,” a group of loosely organized neurons in the medulla oblongata in the brain. Several chemicals, including serotonin and substance P, are released, triggering the nausea and vomiting reflex.
Finding a way to counteract this reflex is important to avoid dehydration and to ensure that the patient can continue to take in nutrients. The customary solution is to prescribe anti-nausea medication, especially during the 24 hours after a round of chemotherapy when nausea and vomiting is at its worst.
Acupuncture is a relevant treatment to apply to digestive disorders caused by chemotherapy. A 2019 randomized trial was completed that looked at the effectiveness of acupuncture versus medication for lung cancer patients suffering from chemotherapy induced nausea and vomiting.
The control group used solely tropisetron hydrochloride, an anti-nausea and anti-emetic medication, thirty minutes before receiving chemotherapy. They were compared to two other groups who received additional acupuncture. The conclusion of the trial resulted in showing that medication combined with acupuncture given 30 minutes before chemotherapy significantly lowered the occurrence of nausea and vomiting compared to the group on medication alone.
Settling the Stomach with the Correct Movement of Qi
According to modern research, acupuncture inhibits the “vomiting center.” It also decreases acid secretion and represses gastric arrhythmias, which are defined as abnormal myoelectrical rhythms of the stomach.
Gastric arrhythmias are similar in meaning to what we call, in TCM, rebellious qi of the stomach. The natural direction of the stomach is downward to the small intestine after it processes the incoming food and drink. When the stomach has become disturbed by an invasion, in this case chemotherapy drugs, it rebels by forcing the contents upward – against its programmed direction of movement. Acupuncture is used, in this case, to restore the correct movement of qi, thereby settling the stomach.
These are just a few explanations of how acupuncture addresses side-effects. Similar studies and positive results have been found for depression and anxiety, hot flashes, leukopenia, fatigue, neuropathy, insomnia, and dyspnea (respiratory function issues). To learn more about how acupuncture helps anxiety read my blog “How to Relieve Stress & Anxiety with Acupuncture.” Acupuncture and TCM can address any disharmony that results from cancer treatment, and support healing following surgical procedures. Chronic Symptoms Following Treatment
The approach in Traditional Chinese Medicine (TCM) is toward unveiling and dealing with the root cause of the illness rather than simply suppressing the symptoms. For chronic symptoms following treatment, this approach will give you a much better chance of returning your body to homeostasis and a sense of well-being.
Frequency of care is essential for overcoming the impact of cancer treatment, especially in the aftermath when you may feel completely depleted. Coming in regularly for acupuncture is important to avoid years of fatigue and lack of resilience. Once a condition moves into the long-term chronic stage, it must be addressed by frequent care.
Don’t be discouraged! Your night sweats, fatigue, dry mouth and skin, difficulty digesting food, etc. can be changed. It will take a firm commitment on your part, but together we can work on this with acupuncture, herbal medicine and dietary and lifestyle changes.
Not only will you start to feel better and regain your energy levels, but TCM can also offer you a creative process of learning and changing if you are engaged in your healing process with a sense of curiosity. This trust and openness towards your healing journey are gifts that TCM leads many people to. Once you are committed and engaged in this way we’ll be able to address the depletion of your deeper resources in a more effective manner.
Below are some recommendations to get started with and a wholesome bone broth recipe to enjoy:
Dietary Recommendations During Cancer Treatment
What are the best foods to eat during and after Cancer Treatment?
It’s likely that your oncologist or PCP will recommend easy foods to eat during chemotherapy or radiation. This section is a good reminder to set up meals ahead of time, or to ask your home care team (family and friends) to provide warm cooked meals that are easy to digest.
According to TCM, warm broth stews or soups with a little meat and rice balanced with steamed or lightly cooked vegetables are considered the perfect food. Bone broth base, with the collagen and minerals from the bones and the richness from the marrow, promotes healing of the connective tissue of the body.
- Drink at least six 8-ounce glasses of warm water, or broth per day. Bone broth is particularly
- helpful to soothe an irritated stomach. You can prepare this a few weeks in advance and place jars of it in your freezer. See recipe below.
- Avoid caffeine as much as possible – it will further deplete your inner resources.
- Eat warm, cooked foods, instead of cold or raw – they will be easier to digest and lead to better nutritional absorption. Avoid spicy, fried, or high fat foods.
- If you lose your sense of taste try seasoning your food so that it has a rich aroma – usually if the food smells good, it will taste good.
- Eat small, frequent meals throughout the day. Nausea is often worse when your stomach is empty, according to the Cleveland clinic.
Bone Broth Recipe
Many people ask me about the benefits of bone broth. According to TCM, warm bone broth stews or soups that include a little meat, rice and a generous portion of lightly cooked vegetables is considered the perfectly balanced food. The collagen and minerals from the bones, and the richness of the marrow, helps to heal the connective tissue in the body, and sources our requirements for essential nutrients.
In the US, we often see a surplus of meat-based protein in our diets. TCM says that only a small amount of animal protein per day is needed to stimulate blood building. Large amounts of meat at a time can tax the digestive system because of the energy expenditure that is needed to break it down. Having a handful of rice in the soup gently stimulates the digestive juices and wakes up peristalsis.
And finally, the lightly cooked vegetables satisfy our other nutritional requirements. They are easily digested and can even act as gentle fiber cleansers of the digestive tract as they travel from the stomach through the intestines. And lastly, home cooked bone broth soup is delicious and will get you the nutrition you need while giving you a satisfying and comforting feeling. To learn more about TCM nutritional practices for increased energy and longevity visit here.
Make the bone broth, then drink it or use it as a base for soup. For best results, and to allow for a healing of the deeper tissues of the body, drink a cup every day for 2-3 months.
Below is my favorite recipe:
- Bones from a whole chicken
- Package of 2-3 large organic beef bones
- White vinegar
- Bay leaf
First break up the chicken carcass and place bones on a tray. I buy an organic chicken, cook it and use the meat, then put the bones into the freezer and use it for broth. Next place the beef bones (found in the butcher section of most larger health food stores) on the tray with the chicken bones.
Sprinkle white vinegar on the bones and put the tray in the oven at 350 degrees until they look slightly browned, usually about 10 minutes or so. The vinegar and browning “opens” the bones so that their nutrients are more available to be released during boiling. Next, drop the bones into the bottom of a large soup pot and cover with water so that the bones are in the bottom fourth of the water.
Bring the pot to a gentle boil and turn down to low so that they are close to simmering. Keep on low for 5 to 8 hours with the lid on. You can also cook your broth in a slow cooker. Bone broth alone is bland, so you can opt to add some bullion and/or vegetables such as carrots, onion and celery for flavor. Remove them at the end and have them with your dinner. When the liquid is cooled, ladle into jars to refrigerate and freeze for later use.
Need support? Feeling weak, feeling terrible – schedule an acupuncture appointment!
Acupuncture and Traditional Chinese Medicine offers you a way to go through your treatment journey with the support you need to counteract the side-effects, fatigue and pain that you may have. Even if you feel too exhausted to follow through with arranging more care for yourself, consider setting up acupuncture appointments every week for yourself. Even better – set them up ahead of time or have someone on your care team do it for you. To learn more about how acupuncture helps with pain read my blog “Acupuncture for the Treatment of Back Pain.”
This will give your body an opportunity to be replenished, and to receive the nurturing that you need. It is part of TCM diagnosis to design treatments to make them right for each person. If you’re feeling extremely weak or emotionally unstable, I can tailor your acupuncture treatment to how you are feeling that given day.
Please don’t hesitate to call whether you are currently going through cancer treatment, had a recent surgery, or are dealing with chronic conditions years later – acupuncture and Traditional Chinese Medicine will assist you in your healing. Click here to book a healing session with me or if you’re looking for acupuncture in Denver.