Cancer of digestive tract includes the malignant tumor such as esophageal cancer, gastric cancer, carcinoma of colon and rectal cancer, the clinical symptoms of which are related to the position of the tumor. The tumor is removed or controlled by means of the antitumor treatment. However, the healthy qi of the human body is often impaired to various degrees because of the operation, chemotherapy and radiotherapy. As a result, the healthy qi is consumed and becomes deficient. In addition, the operational complications or the reactions of chemotherapy and radiotherapy are again related to qi stagnation, blood stasis and the unsmooth circulation of qi and blood. These form the pathogenesis of asthenia in origin and sthenia in superficiality.
1. Syndrome differentiation and treatment
(1) Blood stasis due to qi stagnation
It manifests stabbing pain with distension of esophageal, epigastric and abdominal regions, of which the painful sites mostly correspond to the pathological sites, thoracic and abdominal hardness or hard masses, or occasional eructation, blackish stool, deep red tongue or with ecchymoses, thready and unsmooth pulse. It is advisable to promote blood circulation to remove blood stasis. The prescription used is the modified Xuefu Zhuyu Decoction (Decoction for Removing Blood Stasis in the Chest) or Gexia Zhuyu Decoction (Decoction for Dissipating Blood Stasis under Diaphram). More information, please click to see Gastric Cancer (Carcinoma) in TCM.
In the case of severe qi stagnation, add Yujin (Radix Curcumae), Quangualou (Fructus Trichosanthis), Muxiang (Radix Aucklandiae) and Sharenke (Pericarpium Amomi); in the case of severe blood stasis, add Zhechong (Eupolyhage seu Steleophaga), Qianglangchong (Catharsius), Jixingzi (Semen Impatientis), Zicao (Radix Arnebiae seu Lithospermi) and Danshen (Radix Salviae Mittiorrhizae).
(2) Internal accumulation of dampness and heat
It manifests thoracic and epigastric calor and discomfort worsened by ingestion, concurrent pain, thirst, red tongue, yellowish and greasy fur, taut and rapid or taut and slippery pulse, congestion of fistulous mouth with pain or oozing of liquid when it is pressed after fistulation due to carcinoma of colon. It is advisable to clear away heat and dry dampness. The prescription used is the modified Huanglian Jiedu Decoction (Antidotal Decoction of Coptis). In the case of consumption of yin and body fluids due to dampness and heat, add Shengdihuang (Radix Rehmanniae), Xuanshen (Radix Scrophutariae), Maimendong (Radix Ophiopogonis) and Tianhuafen (Radix Trichosanthis). More information, please click to see Causes of Gastric Cancer in TCM.
In the case of concurrent qi stagnation, add Qingpi (Pericarpium Citri Reticulatae Viride), Chenpi (Pericarpium Citri Reticulatae), Chaihu (Radix Bupleuri), Zhike (Fructus Aurantii) and Baishaoyao (Radix Paeoniae Alba); in the case of excessive heat, add Baihuasheshecao(Herba Hedyotis Diffusae), Longkui (Herba Solani Nigri), Banzhilian ( Herba Scuteltariae Barbatae ) and Shemei ( Herba Duchesneae Indicae); in the case of profuse fluid oozing from the fistulous mouth of carcinoma of colon, add Ermiao Powder (Two Wonderful Drugs Powder).
(3) Incoordination between the liver and stomach
It manifests dysphagia, epigastric tightness and fullness, frequent vomiting and regurgitation or eructation, occasional inclination to sigh, distending pain of hypochondriac regions, vexation, irascibility, thin fur and taut pulse. It is advisable to disperse the liver and regulate the stomach. The prescription used is the modified Chaihu Shugan Decoction (Bupleurum Decoction for Dispersing the Liver). In the case of severe adversely rising gastric qi and lingering vomiting and nausea, add Xuanfuhua (Flos Inulae), Daizheshi (Haematitum), Zhuru (Caulis Bambusae in Taeniam), Huanglian (Rhizoma Coptidis), Wuzhuyu (Fructus Euodiae) and Jiangbanxia (prepared Rhizoma Pinelliae). More information, please click to see Symptoms of Gastric Cancer in TCM.
(4) Obstruction of phlegm stagnation intermingled with blood stasis
It manifests hardness and pain of thoracic, epigastric and abdominal tumorous regions, pain with definite site or lumps, thoracic and diaphragmatic distension and tightness, vomiting of sputum and saliva, or blackish stool, dyschezia or stool with pus and blood as well as foul odor, dark red tongue with purple spots or ecchymoses, thready and unsmooth, or thready, slippery and rapid pulse.
It is advisable to resolve phlegm and remove blood stasis. In the case of esophageal carcinoma, use the modified Qige Powder in combination with Taohong Decoction; in the case of gastric carcinoma, use the modified Haizao Yuhu Decoction; in the case of colonic carcinoma and rectal carcinoma, use the modified Yiyi Fuzi Baijiang Powder (Powder of Semen Coicis, Radix Aconiti Praeparata and Herba Patriniae) in combination with Rhubark Powder. More information, please click to see TCM Diagnosis for Gastric Cancer.
In the case of severe vomiting of sputum and saliva, add Quangualou (Fructus Trichosanthis), Fabanxia (Rhizoma Pinellinae Praeparata), Baijiezi (Semen Sinapis Albae) and Daizheshi (Ochra Haematitum); in the case of vomiting like red bean juice or in the case of blackish stool, add Xianhecao (Herba Agrimoniae), Baiji (Rhizoma Bletillae ) and Shensanqi (Radix Notoginseng); in the case of lump in the affected part or subcutaneous phlegm nodules, add Longkui (Herba Solani Nigri), Zhongjiefeng (Folium et Ramulus Sarcandrae),Tieshuye (Folium Cycadis Revolutae) and Baqi (Rhizoma Smilacts Chinensis). Click here to learn more about Rhizoma Bletillae (Baiji).
(5) Yin consumption of the lung and stomach
It manifests emaciation, dry mouth and throat, thirst with inclination to drink, or foul breath, dysphoria with feverish sensation of the chest, palms and soles, thoracic, dorsal and epigastric burning pain, constipation, uncoated and smooth tongue, thready and rapid pulse. It is advisable to nourish yin and fluid of the lung and stomach. In the case of esophageal carcinoma, use the modified Shashen Maidong Decoction (Decoction of Glehnia and Ophiopogon). More information, please click to see Chinese medicine Treatment for Gastric Cancer.
In the case of gastric carcinoma, use the modified Zhuye Shigao Decoction (Lophatherum and Gypsum Decoction). In the case of yin consumption and severe heat, add Shandougen (Radix Sophoare Subprostratae), Pugongying (Herba Taraxaci), Jinyinhua (Flos Lonicerae), Baihuasheshecao (Herba Hedyotis Diffusae) and Banzhilian (Herba Scutellariae Barbatae). In the case of consumption involving hepatorenal yin, use the modified Yiguan Decoction (An Ever Effective Decoction for Nourishing the Liver and Kidney) or Pulsation-Promo-ting Decoction.
(6) Deficiency of both qi and blood
It manifests emaciation, lustreless complexion, lassitude, hypodynamia, short breath, palpitation, dull pain of neoplastic part, pale tongue, thready and weak pulse. It is advisable to supplement qi and tonify blood. The prescription used is the modified Bazhen Decoction (Eight Precious Ingredients Decoction). In the case of concurrent deficiency of yang qi, add Shufuzi (Radix Aconiti Praeparata) and Danganjiang (Rhizoma Zingiberis).
(7) Digestive cancer after radiotherapy and chemotherapy
In the case of arrest of bone marrow, marked leukopenia and thrombocytopenia after the treatment of carcinoma of digestive tract with radiotherapy and chemotherapy, decoct Dangshen (Radix Codonopsis Pilosulae), Danggui (Radix Angeticae Sinensis), Huangqi (Radix Astragali seu Hedysari), Gouqizi (Fructus Lycii), Gusuibu (Rhizoma Drynariae), Cebaiye (Cacumen Biotae), Tianmendong (Radix Asparagi), Dongguazi (Semen Benincasae), Heidou (Semen Sojae Nigrum) and Huzhang (Rhizoma Polygoni Cuspidati). Click here to learn more about Radix Asparagi (Tianmendong). More information, Click here to learn Radix Angelicae Sinensis (Danggui).
2. Rehabilitation methods
(1) Regulating emotions
Teach the patients how to control their emotions by themselves and cultivate the mind. In the case of anxiety, restlessness, pessimism and depression, guide them to relax themselves mentally by means of conversation, reading books and newspapers, recreation, etc.
(2) Recreation therapy
Guide the patients to participate in recreational activities with joyous atmosphere according to the patients' abilities and specific conditions of anticancer therapies. If the patients are in a depressed state, let them listen to more lively, beautiful and elegant music, arrange them to receive convalescence in the beautiful wooded mountains and seasides. More information, please click to see Chinese medicine Treatment for Gastric Cancer.
(3) Acumox and massage
Esophageal carcinoma
Acumox: In the case of anastomotic inflammation, edema and stenosis after the operation, select Zusanli (ST 36), Xiajuxu (ST 39), Danzhong (CV 17), Zhongting (CV 16), Yutang (CV 18) and Neiguan (PC 6) and needle them with the reducing manipulation; in the case of the patients with weak constitution, apply the reinforcing method and reducing method simultaneously and retain the needles for twenty minutes, once a day; in the case of severe reactions of digestive tract after the chemotherapy or radiotherapy, select Neiguan (PC 6), Zusanli (ST 36), Neiting (ST 44) and Zhongwan (CV 12) with concurrent use of the reinforcing and reducing methods and retain the needles for fifteen minutes once a day. Click here to read Causes of Nasopharynx Cancer in TCM.
In the case of failure to receive a radical cure in the patients with late cancer, select Tiantu (CV 22), Danzhong (CV 17), Zusanli (ST 36), Shenzhu (GV 12), Lingtai (GV 10), Zhiyang (GV 9), Geshu (BL 17), Pishu (BL 20), Weishu (BL 21) and Huatuojiaji (EX) with the concurrent use of the reinforcing and reducing methods and retain the needles for twenty to thirty minutes once a day; in the case of deficiency of yang qi, apply moxibustion on Qihai (CV 6) in addition. Click here to read Symptoms of Nasopharynx Cancer in TCM.
Ear acupuncture: Apply the therapy mainly on Shidao (MA- IC 6), Wei, Jiaogan (MA- AH 7) and Xiong (MA-AH 11). Select two or three acupoints each time and retain the needles for an hour. Apply the method once every other day. Or adopt the needle-embedding with the intradermal needles. Embed the needle in each acupoint for five days.
Gastric carcinoma
Acumox: In the case of the patients with the manifestations of dumping syndrome, select Zusanli (ST 36), Zhongwan (CV 12), Xiawan (CV 10), Liangmen (ST 21) and Neiting (ST 44) with the simultaneous use of reinforcing and reducing methods. Besides, additional moxibustion is applicable to Zusanli (ST 36), Weishu (BL 21) and Qihai (CV 6). In the case of severe reaction of digestive tract after the chemotherapy, select Zusanli (ST 36), Neiguan (PC 6), Waiguan (TE 5) and Neiting (ST 44). Adopt the reducing method and retain the needles for fifteen to twenty minutes. The therapy is preferred two to four hours before the chemotherapy.
In the case of severe gastralgia in the patients with late gastric cancer, select Zusanli (ST 36) and Zhongwan (CV 12) with concurrent use of reinforcing and reducing methods. Besides, the reducing method or the cupping therapy is applicable to Gongsun (SP 4). These methods have better analgesic effect. In the case of splenogastric asthenic cold and vomiting, select Qihai (CV 6), Guanyuan (CV 4), Zusanli (ST 36) and Geshu (BL 17). Moxibustion is applicable to all the above acupoints additionally. Click here to read TCM Diagnosis for Nasopharynx Cancer.
Ear acupuncture: As for the ear acupuncture therapy, mainly select Fei (MA-IC 1), Pi, Jiaogan (MA-AH 7) and Gan (MA-SC 5). Select two or three acupoints each time and retain the needles for an hour. Apply the therapy once every other day. Or adopt the needle-embedding method with the intradermal needles. Embed each acupoint for five days.
Colonic cancer and rectal cancer
Acumox:
Select Zusanli (ST 36), Dachangshu (BL 25), Guanyuan (CV 4), Tianshu (ST 25), Shangjuxu (ST 37), Xiajuxu (ST 39) and Changqiang (GV 1) with the simultaneous application of the reinforcing and reducing methods. Retain the needles for twenty minutes once a day. In the case of severe nausea and vomiting, add Neiguan (PC 6) and needle it with the reducing method; in the case of severe abdominalgia, Gongsun (SP 4) with the reducing method; in the case of general weakness and hypodynamia, apply moxibustion on Qihai (CV 6) and Guanyuan (CV 4) additionally. Click here to read Chinese medicine Treatment for Nasopharynx Cancer.
Ear acupuncture:
As for the ear acupuncture therapy, mainly select Dachang, Xiaochang, Fu, Jiaogan and Pixie. Select two or three acupoints each time and retain the needles for an hour. Or adopt the needle-embedding therapy with the intradermal needles, or apply Wangbuliuxingzi (Semen Vaccariae) on the acupoint and press it.
Massage:
Mainly press the acupoints of stomach meridian of foot-yangming, spleen meridian of foot-taiyin, large intestine meridian of hand-yangming and conception vessel. Besides, it is advisable to adopt the manipulations of horizontally rubbing the upper abdomen, obliquely rubbing the abdomen and rubbing the periumbilical region. For the patients failing to receive a radical cure, massage is not advisable on the local part of tumor. But it is advisable to digitally press, scrub and knead the relevant acupoints on the abdomen, back and limbs such as Zusanli (ST 36), Weishu (BL 21), Pishu (BL 20), Qihai (CV 6), Neiguan (PC 6), Waiguan (TE 5), Danzhong (CV 17) and Tiantu (CV 22). The patients may select Zusanli (ST 36), Shangwan (CV 13), Zhongwan (CV 12) and Xia-wan (CV 10) to apply self massage. Rub the acupoints with the palm for fifteen minutes one hour after the meals every day. Click here to read Liver Cancer in TCM.
3. Dietary therapy
In the case of post operational anastomotic inflammation and edema, select Shanyao Lianyi Gruel (Gruel of Rhizome Discoreae, Semen Nelumbinis and Semen Coicis) and Lizhi Biandou Decoction (Decoction of Lychee and Hyacinth Bean); in the case of yin consumption of the lung and stomach or yin deficiency occurring in other syndromes, select Five-Juice Drink and Mulberry Paste; in the case of the patients with late cancer failing to receive a radical cure, select Lingjiao Yiyiren Gruel (Gruel of Fructus Trapae Bispinosae and Semen Coicis ) and fresh fish jelly.
The patients with esophageal cancer and gastric cancer may select Dysphagia Paste or drink goose's blood (draw five to ten ml of blood from the vessel under the wing of the goose and drink it while it is warm with rice wine). In the case of dysphagia, swallow fresh chives juice (or add milk to it) slowly, 200 to 300ml each day. Besides, it is advisable to eat Egg Stewed with Hetaozhi (Ramulus Juglandis). In the case of gastric cancer due to asthenic cold, cook one Zhudu (Ventriculus Suis), 30g of Hujiao (Fructus Piperis Nigri seu Albi) and a proper amount of condiment until the meat is thoroughly cooked. Eat the meat. Click here to read Causes of Liver Cancer in TCM.
In the case of gastric heat consuming yin, use 50g of fresh lotus root, 200 ml of fresh milk, 50g of shelled peanuts and 30ml of honey. First, pound the shelled peanut and fresh lotus root to paste. Then, add milk and honey to the paste. Finally, decoct all the ingredients together. Take 30 to 50 ml every evening. In the case of colonic cancer and rectal cancer complicated by stool with pus and blood, cut 200g of Machixian (Herba Portulacae) into pieces and pound the pieces to paste to extract the juice. Then, add a proper amount of brown sugar to the juice. Finally, stew the juice in a pot for 20 minutes for oral administration.
In the case of carcinoma of digestive tract with severe qi stagnation, decoct 10g of Xuanfuhua (Flos lnulae), Laifuzi (Semen Raphani) and Shashen (Radix Adenophorae) respectively. Then, keep the decoction and remove the dregs. Next, add 30g of Yiyiren (Semen Coicis) to the decoction to cook gruel for ingestion. One dose is for a day and 15 to 20 days constitute one course of treatment. In the case of severe blood stasis, fry Yubiao (Pneumatophorus Pseudosciaenae) of the yellow croaker with sesame oil until it is crisp. Then, grind it into powder. Each time, use 5g of the powder and additional 3g of the powder of Sanqi (Radix Notoginseng) to be mixed with millet wine for oral administration, one dose a day and 15 to 20 days make up one course of treatment. Click here to read Chinese medicine Treatment for Liver Cancer.
In the case of severe deficiency of qi and blood, wash one live crucian carp clean. Then, cut one garlic into thin slices. Next, place the slices inside the abdomen of the crucian carp. At this time, wrap the crucian carp in a piece of paper and cover the whole crucian carp with mud. Afterwards, roast it till the mud is dry. Take out the crucian carp and ground it into fine powder. Take 3g of the powder each time by mixing it in the decoction of ten jujubes, 12g of Dangshen (Radix Codonopsis Pilosulae) and 6g of Chenpi (Pericarpium Citri Reticulatae), one dose a day. In the case of severe nausea due to yin deficiency, it is advisable to drink goat's milk. More information, click here to learn Pericarpium Citri Reticulatae Viride (Qingpi).
In the case of constipation and abdominal distension, eat 250g of spinach and 6 garlics, or drink Laifuzi Gruel (Gruel of Semen Raphani); in the case of hematochezia, use Huaihua Decoction (Decoction of Flos Sophorae); or Wumei Gruel (Gruel of Fructus Mume) and Stewed Egg with Lotus Juice and Sanqi (Radix Notoginseng); in the case of the patients with late cancer, weak constitution and poor appetite, it is advisable to select Stewed Rabbit's Meat with Jujubes, Jujube Nutrition Gruel, Sweet Thick Soup of Yin'er (Tremella) and Stewed Egg with Hetaozhi (Ramulus Juglandis ). Click here to read Sports Hemoglobinuria in TCM.
Regulating the diet is of vital importance for nursing the patients with carcinoma of digestive tract. After the operation, the patients should mainly ingest the liquid and semiliquid diet, and decrease the amount of each intake and increase the times of intakes. The food should be bland, light and nutritious. Eat more melons, fruits, vegetables, coix seed, edible fungus, mushrooms, lily, water chestnut, Chinese yam, squid, Haishen (Radix Morinae Delavayi), carrot, etc.
These things can not only strengthen the spleen, supplement qi, nourish yin and body fluids, but also have anticancer action to a certain degree. Meanwhile, avoid eating strongly irritative food; eat less pungent, sour, rotten, dry- and hot-natured, hard and heavy foods. It is not advisable to eat more chocolate and condensed milk products like extract of malt. This can avoid giving rise to discomfort in the patients due to the production of acid from these foods after fermentation. In addition, the patients should abstain from meat of pig's head, goose, cock, strong spirit and smoking. Click here to read Causes of Sports Hemoglobinuria in TCM.
4. External treatment with drugs
Dust the Cancer-Eliminating and Pain-Relieving Plaster with the powder of 1g of Shexiang (Moschus) and 1g of Xuejie (Restina Draconis). Then, apply the plaster on Danzhong (CV17) in the case of carcinoma of esophageal tract and the affected part in epigastric region in the case of gastric tumor. Conduct the dressing change once every three days. More information, click here to learn Moschus (Shexiang).
In the case of colonic cancer and rectal cancer with prolonged pyoid, bloody and mucous stool, as well as down-bearing anal pain, the patients may take the hip bath in the decoction of Kushen (Radix Sophorae Flavescentis) twice a day; in the case of accumulation of dampness, heat and toxic substance with profuse oozing of fluid from the fistulous mouth, wash the body locally and externally with the decoction of Jinyinhua (Flos Lonicerae) and Gancao (Radix Glycyrrhizae) or the decoction of Huangbai (Cortex Phellodendri ). Then, apply Huashifen (Powder of Talcum) on the part washed. More information, click here to learn Cortex Phellodendri (HuangBai).