Acupuncture can prevent radiation-induced chronic dry mouth, study finds

ScienceDaily (2011-11-10) -- When given alongside radiation therapy for head and neck cancer, acupuncture has shown for the first time to reduce the debilitating side effect of xerostomia, according to new research.

The Safe and Efficacious Use of Chinese Herbs for Radiotherapy Patients (Part II)

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The Safe and Efficacious Use of Chinese Herbs for Radiotherapy Patients (Part II) Dear Doctors, Nurses, Caregivers, Patients and Friends: In part I  Alex Berks, licensed acupuncturist and Clinical Director of Oncology for Life Cycle Health Center discussed the ways in which Chinese herbs can be used to treat some of the more troubling side effects of radiotherapy. In Part II we'll look at how Chinese herbs have been shown to enhance the effectiveness of radiotherapy. A tumor's sensitivity to radiation is partly dependent on blood supply and oxygenation of the tissues. Herbs can improve both.  It has been reported that tumors have a ratio of anoxic cells that have poor radiation sensitivity and that radiotherapy may reach only about 1/3 of cells in a low oxygenic state. Low tumor infiltration by radiation is considered one of the factors causing tumor relapse.   In Chinese medicine, herbs are generally prescribed in formulas, with modifications based upon the individual's unique presentation. In tailoring herbal formulas to the patient it is said that in Chinese medicine "the patient is treated". This contrasts with biomedicine's focus on cellular pathology, which leads to an approach by which "the disease is treated." Curiously, as biomedicine advances, it is resembling Chinese medicine more and more in providing specific treatments that are individualized to the unique presentation and characteristics of patients' tumors. Research conducted on single herbs, though not representative of how Chinese herbs are most beneficially and clinically applied, illustrates the efficacy and principles of more complex herbal formulas.  An example of this is a study on a Liguistrazine extract of the common Chinese herb Chuan xiong (Radix Liguistici Wallichi). (See link at top, right.) This herb is known in the Chinese pharmocopeia as a blood activator.  It has anti-platelet, anticoagulant and blood vessel dilating properties.  It has also been researched for its ability to increase blood perfusion in the brain.   Results of an animal study with this herb showed that 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 liguistici 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 elevate the sensitivity of tumor tissue to radiotherapy. The studies cited at right 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 a patient's ability to finish the full course of radiotherapy treatment. These findings imply that Chinese herbal medicine could enhance the radiosensitivity of tumors.    In summary, Chinese herbal medicine can be combined efficaciously and safely to enhance radiotherapy's efficacy, improve and prevent side effects of treatment, as well as preserve long term vitality and survival.   To achieve maximum benefit, patients should commence herbal treatment 1 week before starting radiotherapy and continue for at least 6 months after treatment.  Please consult with a trained Chinese Medicine practitioner who is knowledgeable in the integrative support of cancer recovery, such as our team at Life Cycle Health Center. In good health, Alex Berks, L.Ac., Clinical Director, Oncology and Ellen Rudolph, Executive Director, Life Cycle Health Center

Research, Sources, and Viewpoints: Chinese Herbs to Enhance Radiotherapy 1. A 3-part study, "Traditional Chinese Medicine in the Treatment of Breast Cancer" by Isaac Cohen, LAc, OMD, Mary Tagliaferri, MD, LAc & Debu Tripathy, MD includes herbs that are commonly used in radiation such as Chuan Xiong  Read the article >> 2. Another excellent resource is: "Integrating Conventional and Chinese Medicine in Cancer Care: A Clinical Guide"  (Churchill Livingstone Elsevier, 2007) by Tai Lahans, MTCM, M.Ed., L.Ac., a Chinese medicine cancer specialist with over 20 years of experience, practicing in Seattle; Read excepts>> scroll to page 119 for information on Chinese herbs and radiotherapy. Book excerpt: "The purpose of XRT is to kill local and regional cancer cells mainly by making cell-damaging free radicals. Antioxidants, and by extension Chinese herbs that clear heat, are thought to possibly inhibit radiation from having its full effect. The scientific data shows that, counterintuitively, antioxidants, and by extension Chinese herbal formulas that clear heat and nourish yin, actually improve the efficacy of both chemotherapy and XRT. There is no current evidence that herbal medicines will decrease the effect of XRT. ...The vast evidence from research regarding herbal medicine and antioxidant therapies during radiation show that especially blood-regulating herbs like dan shen enhance the effectiveness of radiation." 3. "Breast Cancer and Botanical Medicine", a June 2008 article by Steven Gomberg, L.Ac., CCN, RH (AHG) and Brandon Horn, PhD, JD, L.Ac. provides a context and clinically relevant information on the use of herbs in the treatment of berast cancer. Read the article >> Article excerpt: "...given the wealth of historical information on the safety and efficacy of various herbs (some of them having been used for thousands of years), an herbal regimen could be considered as an additional and potentially effective tool in the treatment of breast cancer." "By utilizing herbs that have both historical data and modern research demonstrating potential mechanisms for efficacy, it is possible to maximize the chances of favorable outcomes while minimizing discomfort associated with conventional therapies."  "...a lack of data on the combined effects of herbs and drugs should not necessarily be a hindrance to their use. The same prudent monitoring that allows for widespread use of untested pharmaceutical combinations can enable us to successfully apply the combined use of herbs and pharmaceuticals. With proper monitoring, herbs can be a substantial asset both in the treatment and prevention of breast cancer."  The information in this newsletter is not a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with your doctor.

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:

1. Zhang Dai-Zhao An Integrated Clinical Approach with Chinese Medicine: Alleviating The Side Effects of Cancer Treatment 2nd Edition (Beijing: Peoples Medical Publishing House, 2007) p. 86.

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.

Acupuncture Eases Radiation-induced Dry Mouth In Cancer Patients

ScienceDaily (Apr. 25, 2009) — Twice weekly acupuncture treatments relieve debilitating symptoms of xerostomia - severe dry mouth - among patients treated with radiation for head and neck cancer, researchers from The University of Texas M. D. Anderson Cancer Center report in the current online issue of Head & Neck.

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Soon I will start working at a radiation center I thought I would post relevant research about acupuncture and radiation therapy