Thursday, January 24, 2013

KICK CANCER: Herbal Support During Chemo and Radiation


Introduction and Disclaimer:
I have been treating cancer patients for some years now, and, for the most part, have used acupuncture as my primary modality.  The reason for this is that some of the oncologists and medical doctors that I work with and who refer patients to me are very uncomfortable about mixing herbs with chemotherapy and with Western medicine generally.  I accepted their conservatism in this regard, since herb-drug interactions are not well-understood and theoretically there is a possibility of doing harm by mixing herbs with drugs.  So I would use only acupuncture to treat my patients for their neuropathy, or their Tamoxifen-related joint pain, or whatever. 

More recently I have changed my thinking on this topic.  In China, oncologists have been combining herbs with conventional cancer therapy for decades, to good effect.  There is an entire branch of herbal medicine, called fu zheng therapy, that utilizes herbs to strengthen the patient and minimize side effects during chemo and radiation.  To disregard the clinical experience of thousands of Chinese doctors and their patients when it comes to optimizing outcomes and minimizing side effects during cancer treatment seems kind of crazy to me.  And for Western doctors to dismiss this accumulated knowledge and experience is arrogant and patronizing.

So, for my patients who wish to integrate herbal medicine into their cancer care, I have crafted this modified fu zheng formula.  About half the herbs here are Chinese herbs that research has shown to boost the immune system, regulate blood counts, etc., during cancer treatment.  The remaining herbs are plants that have a history of use as anti-cancer herbs.  After all, why stop at treating side effects?  I recently lost a patient, a patient who had become a dear friend, to brain cancer.  After she died, I had to do some deep and painful soul-searching.  What kind of physician was I, if I had not done everything in my power to prolong her life? After she died, I vowed to make available to my patients my best-bet formula not just to get them through their cancer treatment, but to try to eliminate their cancer altogether.

Please note that, despite the promise of its name, I am not claiming that this formula cures cancer.  I find nothing more despicable than companies and websites that prey on the desperation of cancer patients to sell dubious products cloaked in glowing claims and effusive testimonies.  What I DO want to offer is high-quality herbal support, and also to place a positive mental suggestion in my patient’s mind every time they take their herbs.  Kick Cancer!  Mobilize every resource you have available to do it!  Don’t give in to depressing statistics, genomic determinism, and feelings of powerlessness or hopelessness.  Positive attitude, a loving support network, healthy diet, rest and exercise, regular acupuncture or bodywork – these are all ways to nudge your body to overcome cancer.  As far as I’m concerned, the anti-cancer herbs are just one more nudge to the system, one more lever to push to urge your body to optimize and mobilize and beat this thing.  It is my deep and fervent desire that all these nudges do their job and leave my patients cancer-free.

Ingredients:
Huang qi – Astragalus membranaceus root
Ling zhi – Ganoderma lucidum fruiting body
Bai zhu – Atractylodes macrocephala rhizome
Nu zhen zi – Ligustrum lucidum fruit
Ji xue teng – Millettia dielsiana root and vine
Burdock – Arctium lappa root (fresh)
Dandelion – Taraxacum officinale entire plant (fresh)
Dokudami – Houttuynia cordata herb (fresh)
Ashitaba – Angelica keiskei leaf (fresh)
Pau d’arco – Tabebuia impetiginosa bark
Gotu kola – Centella asiatica leaf and stem (fresh)
Sheng jiang – Zingiber officinale root (fresh)
Ban xia – Pinellia ternata rhizome (treated)
Sheng gan cao – Glycyrrhiza uralensis root
Ethanol
Water

Effects:
Boost immune system, allay fatigue, stabilize white and red blood cell levels, reduce or eliminate nausea and vomiting, prevent or minimize allergic skin rashes.  This formula also contains herbs that have a long tradition of use in treating cancer.  Though the formula was designed for patients in active treatment, it is also recommended for patients with cancer who are not currently undergoing chemo or radiation.

Dosage:
Four full squirts of the dropper, twice a day.  I recommend squirting the tincture in a cup of boiling water, to boil off most of the alcohol before drinking it and to minimize the harshness of the alcohol before putting it into what may be your already chemo-irritated mouth.  Make sure to shake the bottle each time to distribute the abundant astragalus and reishi polysaccharides, which will have settled to the bottom of the bottle.  Finally, if you are currently undergoing chemotherapy, don’t take any herbs on the day of chemo, to minimize the potential for herb-drug interactions.

If after a couple weeks of use you don’t notice any change in how you are feeling, feel free to increase your dose from four squirts to six or even seven or eight. Some people will require a higher dose to see effects.  Also, chemotherapeutic agents can be so toxic that any positive biological effect of the herbs is trumped by the negative side-effects of chemo.  This isn’t necessarily a reason to discontinue the herbs, since they will continue to protect your healthy cells, detoxify your liver, benefit your circulation, etc. even if you’re not feeling great.

Product Description:
The astute reader of this blog will have noticed that the three herbs huang qi (astragalus), bai zhu (atractylodes), and ling zhi (ganoderma/reishi), are the chief herbs in my fall/winter tonic, Jade Defense REISHI. Indeed, this overlap is not accidental.  Just as it is important to boost the qi and mobilize the immune system to keep from catching colds, it is important to do these things to stay strong during cancer treatment.  From a biomedical perspective, these herbs increase interferon levels, boost white blood cell count, mobilize the immune system, and protect healthy cells from radiation damage.  They also help to increase appetite and energy.  In addition to their palliative and supportive effects, it is important to remember that astragalus and reishi polysaccharides also have anti-tumor effects as well.

In fu zheng therapy, it is considered important to tonify the blood and yin as well as the qi.  Nu zhen zi (ligustrum) and ji xue teng (millettia) are the main herbs that accomplish this.  These herbs help to keep white and red blood cell counts up, and the ji xue teng also helps combat damage to the microcirculation that occurs with some chemo agents and which can lead to peripheral neuropathy.  I would ordinarily include dang gui (Chinese angelica root) here because it is a great blood tonic, but have excluded it because its potential estrogenic effects are contraindicated in some cancers.

Burdock and dandelion is a traditional pairing often used by Western herbalists to treat cancer.  They are both cooling and detoxifying; cancer is thought of in many traditional medical systems as a disorder of heat and toxicity, and burdock and dandelion treat both.  Dokudami (houttuynia) and ashitaba (Japanese angelica leaf) are similarly used in Japanese folk medicine as anti-cancer herbs.  They are two of my favorite herbs to eat fresh (I grow them in my garden).  Speaking of which, the burdock, dandelion, dokudami, and ashitaba were all tinctured fresh, meaning that they were extracted at the peak of freshness from live plants rather than from dried plants.  It is my belief that fresh-tinctured herbs have a stronger vitality than medicines made from dry herbs.

The gotu kola (centella) in this formula is also home-grown and fresh-tinctured.  I include it here mostly for its neuroprotective, circulation-stimulating, and skin-healing effects.  My hope is that it will help prevent peripheral neuropathy and skin rashes due to chemo.  For the former effect it combines well with the ji xue teng; for the latter with the burdock and dandelion.

Pau d’arco (tabebuia) is the final anti-cancer herb in the formula.  It has a long tradition of use in South America, mostly for skin problems, autoimmune disorders, and cancer.

Sheng jiang (fresh ginger) and ban xia (pinellia) are included for their anti-nausea effects.  They work well with the huang qi and bai zhu to strengthen and protect the stomach to prevent nausea.  The final herb in the mix, gan cao (licorice), is added to harmonize the formula – its job is to make all the other ingredients get along and work well together as a team. Licorice is an important detoxifying herb in its own right; the compound in it known as glycyrrhizin is metabolized into glucoronic acid, which turns toxic non-water-soluble substance water-soluble so that they may be excreted by the body.

Production Notes:
In the past couple years I have been expanding my liquid herb pharmacy, creating ethanol/water tinctures of single herbs that I use a lot.  This is my first Green Monkey Pharmacy product made entirely by combining single herb extracts rather than extracting the formula all at once.  The astragalus and the reishi were separately extracted in a relatively large amount of pure water over low heat in order to maximize the amount of immune-stimulating polysaccharides in the final solution, then boiled down.  The remaining dry herbs were separately ground and percolated to a final strength of 1:3.  The fresh herbs were extracted with 95% ethanol for maximal extraction of alcohol- and water-soluble compounds, at 1:2 fresh-weight to alcohol ratio.  Finally, these various extracts were combined.  Because the immune-stimulating polysaccharides are water-soluble and not alcohol-soluble, about half the polysaccharide mass precipitates out of solution once the extracts are combined.  This is why you need to shake the bottle well each time you take a dose.

One Other Herb You May Want to Consider:
I recently had the opportunity to dig up the root of pokeweed, Phytolacca americana.  Poke is a beautiful and vigorous plant common in the American South and Midwest.  It was used by the Eclectic physicians in the 1800s and by Native American tribes, doubtless for much longer than that.  Its primary uses are as a lymphatic stimulant, for swollen glands, sore throat, mastitis, skin problems, arthritis, and cancer - one of its common names, "cancer jalap," reflects its folk use as a cancer remedy.  (Probably THE primary use of poke is the berry juice as pediatric face paint, but that does not concern us here).  The whole plant is extremely toxic, and the effective dose is a mere drop of tincture up to five or six drops, mixed in a glass of water and drunk two or three times a day.  A very similar plant, shang lu (Phytolacca acinosa), is used in traditional Chinese medicine primarily for its toxic effects, i.e. to cause a cathartic expulsion of stool to treat severe edema and constipation.  It is also used topically for sores and carbuncles.

Poke's toxicity is clearly problematic, as a careless patient could easily cause severe gastric upset, blood clots, coma, or even death by taking too much.  For this reason I didn’t include it in Kick Cancer.  However, the potential benefits of careful low-dose treatments in my opinion outweigh the potential dangers, and I encourage patients – especially patients who opt to forego conventional treatment – to consider a course of poke treatment.

The chemistry of pokeweed is very interesting, and more compelling than any other anti-cancer herb I know of.  The active anti-cancer component is a lectin known as pokeweed mitogen (PWM).  Lectins are antibody-like chemicals that are involved in biological recognition phenomena.  They are sugar-binding proteins that attach selectively to specific sugars that they encounter.  When those sugars are part of a cell’s molecular signature at the cell membrane, lectins cause those cells to clump.  There is some intriguing research suggesting that pokeweed mitogen has an affinity for cancer cells, signaling the immune system to then clean up the clumps and eliminate the cancerous cells.

Additionally, PWM induces cell division in B and T lymphocytes – this is what makes it a mitogen: it induces mitosis or cell division. But what is interesting is that by increasing T and B cell proliferation, PWM enhances two separate mechanisms that target cancer cells. T cells directly and indirectly kill antigenic tumor cells, and B cells are raw material for plasma cells, which develop into antibodies, which check the growth of cancer cells.

It’s kind of like a special ops team marking a target with a laser beam from a mile away, then a jetfighter swooping over and bombing the marked target.  Poke serves as both the laser-wielding special operative and the jetfighter.

The idea of purposely causing cell proliferation may sound kind of scary, since after all what is cancer if not cell division run amok?  Here I think that dosage and duration of treatment is important, and this is why I’d rather talk to you in person if you’re interested in trying it out rather than just make it part of this formula.  I am currently making an alcohol extract for careful internal use, and an oil extract for external use (for lymphatic swellings, skin cancers, and close-to-the-surface tumors, such as many breast cancers).  

It is probably simplistic to think that poke will help in all cancers, since "cancer" is actually many different diseases.  Personally, I would be wary of giving poke extract to patients with one of the blood cancers, since they are already having issues with proliferation of certain kinds of blood cells.  Poke is strong medicine, far on the pharmaceutical end of the food-to-drug spectrum on which we can place herbal medicines.  But its novel mechanism for stimulating the immune system to go after cancerous cells, and its long history of use as a cancer treatment, make me very excited to be able to offer it to you as another powerful nudge (or should I say "poke"?) to encourage your body to kick cancer.