Helping Cancer Patients: The Integrative East-West Approach

Ka-Kit Hui , MD, FACP, Professor of Medicine and Director of the UCLA Center for East-West Medicine, David Geffen School of Medicine at UCLA

TCM modalities have been used quite extensively in China before, during, and after the use of conventional therapies and can help control symptoms, shorten recovery time, and improve endogenous resistance to disease.

The study of medicine "begins with the patient, continues with the patient, and ends with the patient." --Sir William Osler

These are excellent words to guide medicine—whether Traditional Chinese Medicine or Western medicine. The goals of medicine should be to prevent disease and injury; promote and maintain health; to relieve pain and suffering caused by maladies; to care for and cure those with a malady; to care for those who cannot be cured; to avoid premature death, and if that is not possible, to pursue a peaceful death. While these goals make sense, the translation of these goals into practice is sometimes quite challenging.

All forms of medicine aim to ease human suffering and improve quality of life; they differ only in their approaches to the realization of this goal. The blending of the Eastern and Western approaches to health and healing can maximize the safety and effectiveness of care in an accessible and affordable manner.

Traditional Chinese Medicine (TCM) is a comprehensive system of medicine complete with its own theories and principles that guide various diagnostic and therapeutic modalities. TCM is a logical, elegant and independent system of thought and practice that continues to develop as a result of a process of extensive clinical observations, testing, and critical thinking. Characterized by more than 2500 years of use and refinement, TCM represents a significant alternative to the conventional biomedical model and continues to be used today by a sizable number of patients, both in the Far East and increasingly here in the West.

TCM differs from Western medicine in its conceptualization of health and disease through a holistic view of the person. TCM emphasizes the inseparable nature of body-mind-spirit, the centrality of dynamic homeostatic balance, the importance of energetic flow, and self-healing. It recognizes the impact that physical, nutritional, psychological, and environmental factors have on health. It emphasizes the functional and energetic systems of the human body and, consequently, regards illness as an imbalance in the systems.

TCM utilizes a number of therapeutic techniques including acupuncture, acupressure, therapeutic massage, dietary and herbal counseling, mind-body exercise, and patient education.

Acupuncture is a method of sending a signal to the body by needle or other means of stimulation to "turn on" its own self-healing capacity. In 1997, the National Institute of Health (NIH) recommended that acupuncture be used to treat post-operative and chemotherapy-related nausea and vomiting. The NIH also recommended acupuncture as an adjunctive treatment for addiction, stroke rehabilitation, headaches, menstrual cramps, fibromyalgia, myofascial pain syndromes, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma. Therapeutic massage is also used as part of TCM and has been shown to be effective in managing pain.

Mind-body exercises such as Tai Chi and QiGong utilize movement with focused concentration, meditation and breathing methods to induce physical and mental harmony. The benefits of Tai Chi and QiGong include stress reduction, enhancing oxygen consumption, improving cardiovascular function, enhancing immunity, reducing mood disturbance, lowering body fat, improving balance, increasing flexibility, and enhancing muscle strength. [Editor's note: The Ted Mann Family Resource Center offers a weekly class in QiGong taught by a QiGong Master. It is open to people with a cancer diagnosis and a caregiver.]

Herbs are often used as part of TCM; however, they should be used only under the guidance of an experienced Chinese herbalist. Patients with a serious disease should consult a physician and a pharmacist before using herbal remedies in conjunction with pharmaceuticals. Dietary therapy is also part of TCM. Practitioners of TCM often prescribe specific foods; however, this is always done on an individual basis based on the TCM assessment.

The Benefits of TCM in the Treatment of Cancer Patients

The standards of care for cancer treatment established by Western medicine are necessary for the treatment of existing disease. TCM modalities have been used quite extensively in China before, during, and after the use of conventional therapies and can help control symptoms, shorten recovery time, and improve endogenous resistance to disease.

TCM views the cancerous process as a systemic disease; the local growth is a manifestation of a larger problem. The pathogenic factors analyzed in TCM’s approach to cancer treatment include external/noxious stimuli, psychological/emotional factors, lifestyle factors, and the deficiency of the mind-body-spirit system. There is a constant tug-of-war in the cancerous process between the noxious stimuli and endogenous resistance. Any factor, no matter how seemingly indirect, that increases the amount of noxious stimuli and/or decreases one’s endogenous resistance can accelerate the cancerous process.

TCM’s approach to cancer treatment emphasizes an understanding of each patient, not merely the patient’s specific form of cancer. Because of its focus on the individual patient, TCM results in the design of a flexible, individualized therapeutic approach that encompasses the differential diagnosis of the pathophysiogical state of the patient.

In China , and increasingly in the US , patients with cancer seek TCM for the following:

• Prevention of cancer
• Symptom management
• Improvement in their quality of life
• Improved ability to tolerate conventional therapies
• Prevention of disease progression
• Maintenance of remission
• A new and different philosophy of life, and a new approach to health and disease

TCM is most effective in the management of pain, fatigue, nausea, stress, dry mouth, and reducing the complications from chemotherapy, radiation, and surgery.

At the Center for East-West Medicine, we treat patients with cancer by integrating the best of modern Western medicine and TCM. Acupuncture and stimulation of specific points have been shown to be effective for patients who receive chemotherapy and feel nauseated. It is sometimes effective for pain, but patients who are on anticoagulants generally should avoid acupuncture. Therapeutic massage is also helpful and has been shown to be beneficial for anxiety, nausea, and manual lymph drainage for lymphedema.

The UCLA Center for East-West Medicine

The mission of the Center is to improve health, well-being, and the quality of life of people by blending the best of modern Western medicine with Traditional Chinese Medicine to provide healthcare that is safe, effective, affordable, and accessible for people, families and communities. The Center has established a model system of comprehensive care with emphasis on health promotion, disease prevention, treatment, and rehabilitation through an integrated practice of East-West medicine.

The Center for East-West medicine focuses on assisting patients to care for themselves, to manage pain, and to manage the stress that both accompanies and may also cause further pain. Central to the Center's approach is a holistic approach, one that focuses on the whole person, and not on a single disease—or combination of diseases—afflicting the patient. Key to the success of our integrative East-West model, which blends the best of both Western medicine and TCM, is the empowerment of the patient. East-West healthcare enlists the patient as a central figure in the healing process. This enables us to not merely treat chronic pain or assist in a patient’s rehabilitation, but to actively involve the patient in the ongoing process of health promotion and disease prevention.

At the Center, our patients learn how to prevent overloading, how the lack of exercise or inappropriate exercise must be replaced by a balanced exercise program, and how nutrition tailored to the individual is vital. They are taught how to build up their body's reserve so that the body can reset its pain/no pain balance. Most important, they learn self-healing. We teach effective and easy-to-implement techniques so that patients and caregivers can manage their pain and the stressors in their lives.

The Clinic's staff, which includes seven US-trained and board-certified physicians in primary care with advanced training in Chinese medicine and four medical experts trained in integrative Chinese and Western medicine in China, develops integrative East-West treatment plans to meet each patient's needs. Therapeutic techniques include acupuncture, acupressure, therapeutic massage, dietary and herbal counseling, mind-body exercise, and patient education.

http://www.cancerresources.mednet.ucla.edu/5_info/5c_archive_lec/2004/lec_eastwest_hui.htm