Acupuncture For Neuropathy in Chemo Patients
January 21, 2020Cervical Dystonia: A Case Study
May 8, 2020Brief summary: on March 1st, 2017, a 50-year-old female with a diagnosis of breast cancer with multiple metastases in her lungs, brain and adrenal glands, came to the Sunrise Neuro-Acupuncture Integrative clinic. During a period of two years and 10 months, she received acupuncture treatments and took Chinese herbal prescriptions. She was able to remain totally independent, with a minimal amount of pain and medications.
Initial visit
Date: March 1st, 2017. A 50-year-old female came to my clinic. Her primary diagnosis had been stage IV breast cancer since 2013. In February 2016, she developed multiple metastases in her lungs and adrenal glands. Her main complaint was fatigue and a severe, dry cough which had lasted for several months. Her current medication: Tamoxifen and steroids. Her additional complaints were night sweats, shortness of breath upon exertion and abdominal bloating. Her pulse was deep and slippery. Her tongue was small, with tooth marks, slightly purplish with thin yellow coating to the root and red tip.
Objective findings:
T2 (4.3 cm), N1 (1/2) carcinoma of the right breast (ER positive, HER-2/neu negative). Status post mastectomy, sentinel lymph node biopsy in February 2013. Adjuvant radiotherapy to the chest wall and regional lymphatics December 2013. Pulmonary metastases in September 2016.
A CT scan of the thorax and abdomen showed extensive pulmonary metastatic disease. The largest mass was in the right lower lobe appeared slightly larger while other lesions appeared similar in appearance. The largest mass was 5.3 cm x 4.2 cm. Bilateral adrenal nodules were most concerning for metastasis. There was a suspected involuting left ovarian cyst. There was no metastasis in her bones according to the CT scan.
TCM diagnosis: Spleen-Lung Qi deficiency, Liver-Spleen disharmony, phlegm-blood stasis in the chest.
Treatment strategy: boost Spleen, Lung qi, harmonize Spleen and Liver, resolve blood and phlegm stasis, stop cough.
Chinese herbs: Xiao Chai Hu modification Huang Qi, Chai Hu, Dang gui wei etc. Concentrated powder. 6-9 grams per day dissolved in the water. Avoid cold and uncooked food.
Second visit. March 6th, 2017. Pt state that her cough become less severe, hot flashes has reduced. Main complaint: sensation of cold in the abdomen.
Pulse and Tongue- without significant change.
Chinese herbs: Xiang Sha Liu Jun Zi Wan modification. Huang Qi, Dang Shen, Bai Zhu, Fu ling etc.
April- July 2017. Patient continued herbal treatment with gradual improvement in her cough, hot flashes during the night and fatigue. In July patient had her ovaries removed due to metastatic disease.
14th visit. August 25th, 2017. Patient stated that her cough had reduced and she almost didn’t have one. Her hot flashes also reduced but not completely and most probably it was related to her steroid intake. Sleep had improved also but patient felt weak during the daytime. Patient also complained of numbness and a tingling sensation in her right arm. She was suggested to report it to her medical doctor and probably an MRI was needed.
15th visit. November 9th, 2017. The brain scan revealed 21 small brain metastases affecting both the cerebrum and cerebellum. In November, the patient underwent CyberKnife radiation therapy for her metastatic brain disease. On assessment patients looked extremely weak, fatigued, had weakness in both legs and walked in with the cane. Tongue: pale, small body, gray, whitish moist coating. Pulse was weak and slippery.
TCM diagnosis: Spleen, Kidney Qi-Yang deficiency, phlegm-blood stasis.
Acupuncture: Zhu’s scalp acupuncture to reduce brain edema.
Chinese herbs: Huang Qi, Huang Jing, Yin Yang Huo, Shan yao etc. Cordyceps
16th visit. Patient stated that she reduced the amount of her prednisolone and she felt nauseated, and suffered from headaches. Tongue and pulse had not changed.
Acupuncture: Zhu scalp therapy. PC 6, CV 12, ST 36. Acupuncture to the neck.
Chinese herbs: Xiang Sha Liu Jun Zi Wan modification plus cordyceps, Siberian Ginseng.
18th visit. December 18th, 2017. Patient stated that her headaches and dizziness had improved. Legs were stronger. The same treatment was continued.
20th visit. February 22, 2018. Patient remained on steroids. In general, felt good. Minor cough and dizziness but overall felt better than in December. The same treatment was continued.
From March 2018 to January 2019 patient remained stable with occasional episodes of nausea or vomiting and/or hot flashes and fluctuation of blood pressure due to steroids intake. But stated that she gained a bit more energy and was able to walk outside and participate in some moderate activities. Her cough had reduced significantly.
February 5th, 2019. Patients complained of severe vomiting, nausea and headaches. Pulse was weak and slippery. Tongue had a small bogy, greasy coating. TCM diagnosis: External wind-cold invasion, Spleen Qi, kidney Yang deficiency.
Acupuncture: St 36, CV12, 6, PC 6, Zhu’s scalp acupuncture.
Chinese herbs: Huo Xiang Zheng Qi Tang and Wu ling San modification
February-March 2019. With Chinese herbs, acupuncture and her regular medications, the nausea and episodes of vomiting were under control. Patient was prescribed Hydromorphone (dilaudid) and Haloperidol for nausea.
March 8th, 2019. Note from her doctor’s assessment. “Patient describes development of headaches, nausea and vomiting mid to early February. She was started on steroids approximately 2-3 weeks ago, in addition to Haldol for nausea. She also started taking dilaudid 1mg 4 X per day for headaches. Since starting the steroids, she is much improved. She no longer has headaches, nausea or vomiting. She does continue to describe periods of forgetfulness and episodes where she has forgotten how to perform common functions like pressing the button in the elevator and turning on the stove. She no longer has a cough. She uses a walker. Upon examination, she was not in any distress.”
April-November 2019. Patient continued with regular acupuncture treatment and Chinese herbs. Her power and energy gradually declined. However, patient was still totally independent and able to perform her daily tasks. She walked with the cane. She complained about occipital headaches and nausea mostly in the morning, but after taking her regular medications and Chinese herbs, pain was under control for the most part of the day.
December 24th, 2019. Patient woke up in the middle of the night with a severe headache and vomiting. After that, the patient fell into a deep coma. During the following 3 days, the patient remained in a coma. She passed away on December 27th, 2019.
Conclusion. Although, traditional Chinese medicine does not provide a cure for cancer patients, it can provide relief for patients suffering from cancer. Traditional Chinese medicine has been an official medical system in China for almost 2,000 years. According to research that included 253,434 patients in China, Chinese medicine was integrated into the standard treatment in 90% of cases as an adjuvant treatment. Such treatment can help patients reduce the side effect of medication, chemo- and radiotherapy, improve quality of life and reduce patient’s symptoms. Studies from Taiwan also indicate that the combination of Chinese medicine with regular treatment can prolong a patient’s life. In this case study, a 50-year-old woman with advanced breast cancer was able to survive for 2 years and 10 months using combination of Western medication, Chinese herbs and acupuncture treatment. Despite the fact that she came to the clinic with multiple large metastases in her lungs and later she had developed 21 metastases to her brain, she was able to stay independent for almost 3 years. Her initial complaint of a severe cough was totally gone after 1 year of treatment and her headaches and nausea were more or less under control. During the treatment period she hadn’t developed neurological signs despite the multiple metastases in her brain. Unfortunately, the patient sought help when the disease was already in its advanced stages. In this case, the Chinese medicine’s ability to help is very limited, but yet can be impressive.
In my clinic, I provide support to patient with different types of cancer including breast, colon, ovarian and others. Some patients with advanced stages and bone metastases are still alive and able to function, even after 6 years of continued integrated treatment.
Lee, Yuan-Wen & Chen, Ta-Liang & Shih, Yu-Ru & Tsai, Chu-Lin & Chang, Chuen-Chau & Liang, Hung-Hua & Tseng, Sung Hui & Chien, Shu-Chen & Wang, Ching-Chiung. (2014). Adjunctive traditional Chinese medicine therapy improves survival in patients with advanced breast cancer: A population-based study. Cancer. 120. 10.1002/cncr.28579.
Chang, C. Y.-Y., Yang, P.-Y., Tsai, F.-J., Li, T.-M., Chiou, J.-S., Chen, C.-J., … Lin, Y.-J. (2019). Integrated Chinese Herbal Medicine Therapy Improves the Survival of Patients With Ovarian Cancer. Integrative Cancer Therapies. https://doi.org/10.1177/1534735419881497
Li X, Yang G, Li X, et al. Traditional Chinese Medicine in Cancer Care: A Review of Controlled Clinical Studies Published in Chinese. El-Rifai W, ed. PLoS ONE. 2013;8(4):e60338. doi:10.1371/journal.pone.0060338. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3616129/ Accessed October 11, 2017.
