Thursday, November 19, 2009

The Use of Chinese Herbs With Radiotherapy



By Alex Berks L. Ac. Dipl. Herbs, FABORM
Clinical Director of Chinese Medicine Oncology



Integrating Chinese herbal medicine with conventional radiotherapy can be of immense benefit to a cancer patient. In the scientific literature it is reported across many studies from China that the integration of both medicines is better than either one alone.

This article addresses the prescription of Chinese herbs for a radiation patient. Chinese Medicine includes acupuncture, qi gong, tai qi, massage and diet therapies, all of which are of great value to a cancer patient.

Radiation therapy can injure surrounding healthy tissue, damage fragile mucosal barriers in the lungs and intestines, injure salivary production, cause digestive problems, dryness, inflammation and even scorching depending on location, intensity and duration of the treatment. Radiotherapy can also injure the bone marrow. While the targeting of radiation therapy has vastly improved to protect surrounding tissue, radiation therapy is still a significant challenge.

From a Chinese Medicine perspective the heat from radiotherapy that is intense enough to destroy tissue generates a "toxic heat". Cancer is itself a toxin. Radiotherapy is a toxin to fight a toxin.

Herbs that rebalance the body can prevent side effects of radiotherapy, restore health and vitality, and prevent relapse and metastasis. Rebalancing is a concept of Chinese Medicine that is a fabulous complement to the cure seeking of Western Medicine.

Rebalancing against radiation toxicity is done along a continuum of signs and symptoms. For example, toxic heat depletes the moistening properties of the blood and injures the mechanisms of energy production. Then the body, in an effort to compensate for the heat, dryness and depletion of fluids, produces phlegm as a substitute lubricant. This phlegm, when combined with heat, can injure the elimination pathways in the bladder and large intestine, stagnate and deplete the blood and cause further weakness. At late stages the vital essence is injured and there is very poor energy production and compensation. Applying Chinese Medicine diagnostic principles and appropriate treatment at each stage is a way to prevent this degeneration and many side-effects.

Research has also shown that Chinese herbs improve the sensitivity of the tumor to radiotherapy.
A tumor's sensitivity to radiation is in part dependent on blood supply and oxygenation of the tissues. Herbs can improve both. It is reported that tumors have a ratio of anoxic cells which have poor radiation sensitivity. Radiation therapy may reach only about 1/3 of cells with a low oxygenic state. Low tumor infiltration by radiation is considered one of the factors causing cancer relapse.


Research studies done on single herbs, though not representative of how herbs are most beneficially applied, are illustrative of the efficacy and principles of multi-herb formulas. An example of this is a study done on a Liguistrazine extract of the common Chinese herb Chuan Xiong (Radix Liguistici Wallichi). This herb is known in the Chinese pharmocopeia as a blood activator. The results of this study showed that the rats responded to the herbal extract with increased microcirculation in caliber, flow speed, flow status and capillary count. It is not hard to see that a formula with this and other synergistic herbs could improve the microcirculation of peri-tumor tissue and the tumor body, increase blood perfusion in the tumor body, improve cell's anoxic state and could elevate the sensitivity for tumor tissue to radiation therapy. (1)

The following studies demonstrate the value of Chinese Herbal Medicine (CHM) in conjuction with radiotherapy (RT) to improve survival rates, lessen the impact of depletion of white blood cells, and improve the ability to finish the full course of treatment.

This study from Chinese Academy of Medical Sciences included 197 nasopharyngeal cancer patients who were treated with Chinese herbs plus radiation therapy compared to radiotherapy alone. The combined therapy group had twice the number of patients survive to five or more years than the radiotherapy alone group. The tumor was killed in more patients in the combined therapy group and the remote metastatic rate was less in the combined group. These findings imply that Chinese herbal medicine could enhance the radiosensitivity of tumors. (2)



Survival Rate N =197

1 year
3 Years
5 years
CHM + RT
91.3%
67.4%
52.4%
RT
80%
33.3%
24%

Disappearance of the tumor
CHM + RT
95.7%
RT
88.6%

Cause of Death
Primary lesion relapse or metastatic lesions
CHM + RT
34.8%
RT
52.4%


In another study researching the efficacy of herbs to prevent and treat side effects of radiation therapy, 71 patients were in an active treatment group with herbs and radiation and the control group was given a placebo herbal formula plus radiation.
The results showed 84.5% were able to finish the full course of radiotherapy versus 63.3% in the control group. The type and staging of the cancer was not revealed.(3)

In another small study, white blood cell counts did not go as low in a combined treated group as they did with radiotherapy alone. One particular formula Fu Zheng Xiao Formula (FZZX), was shown to moderate T-lymphocyte subset. (4)

Another combined herb-radiation study was conducted with nasopharyngeal cancer patients who continued taking herbs for 6 months after the radiation was finished. The 5 year survival rate was 75%. The authors indicate that Chinese medicine combined with radiation improved the effectiveness of radiation therapy while minimizing its toxicity in both the short and long term. In this study there was no mention of a control group. (5)

Mice studies have also showed improved efficacy when radiation and herbs were combined both on white blood cell counts and survival rate. Interestingly, the survival rates were even higher in the mice that were given the herbal mixture 1 week before beginning treatment with radiation. (6)

Many studies, repeatedly show that Chinese herbal medicine formulas can be combined efficaciously and safely to improve life expectancy and prevent adverse side effects of radiation treatment. Herbs should be started 1 week before starting radiotherapy and continue for at least 6 months after treatment to achieve maximum benefit.

Please consult with a trained Chinese Medicine practitioner who is knowledgeable in the integrative support of cancer recovery.


Footnotes:

2. Donald Abrams, Andrew Weil, Integrative Oncology (New York: Oxford University Press, 2009) chapter 13 p. 269.

3. Zhang Dai-Zhao p. 83.

4. Zhang Dai-Zhao p. 83.

5. Zhang Dai-Zhao p. 85.

6. Zhang Dai-Zhao p. 86.