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Acupuncture and Integrative Medicine as a Support System for Patients with Kidney Cancer

Cedars-Sinai Medical Center September 12, 2011. Acupuncture and Integrative Medicine as a Support System for Patients with Kidney Cancer. Lucy Postolov, L.Ac. Master of Traditional Oriental Medicine Diplomate in Acupuncture (NCCAOM)

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Acupuncture and Integrative Medicine as a Support System for Patients with Kidney Cancer

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  1. Cedars-Sinai Medical Center September 12, 2011 Acupuncture and Integrative Medicine as a Support System for Patients with Kidney Cancer Lucy Postolov, L.Ac. Master of Traditional Oriental Medicine Diplomate in Acupuncture (NCCAOM) Allied Health Professional / Cedars-Sinai Medical CenterBoard Certified in Integrative Medicine

  2. From the History of Cancer

  3. Integrative Medicine is a part of Modern Medicine • Mainstream Medicine • Allopathic Medicine • CAM • Complimentary and Alternative Medicine

  4. An Increasing Number of Cancer Patients are Turning to Complimentary and Alternative Medicine (CAM) CAM use among cancer patients is diverse and varies by region • National Center for CAM estimates • 7-54% of cancer patients use CAM • 48-88% of cancer patients used CAM while being treated in comprehensive cancer centers in the USA

  5. How Acupuncture Works The Eastern Philosophical Point of View

  6. How Acupuncture Works The Western Medical Point of View From “Neuro-Acupuncture”, Cho ZH et al, Q-puncture, Inc. 2001

  7. How Acupuncture Works:Western TheoryStimulation of Neurotransmitters Dopamine Norepinephrine Endorphins Complimentary & Alternative Medicine Freeman Lawlis, 2001

  8. NIH Consensus Development Panel on Acupuncture • Promising results have emerged, for example, showing efficacy of acupuncture in adult postoperative and chemotherapy nausea and vomiting and in postoperative dental pain. There are other situations, such as addiction, strokerehabilitation, headache, menstrual cramps, tenniselbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma, in which acupuncture may be useful as adjunct treatment or an acceptable alternative or be included in a comprehensive management program. Further research is likely to uncover additional areas where acupuncture interventions will be useful. JAMA. 1998;280:1518-1524

  9. Kidney Organ in Western Medicine

  10. Kidney Organ & Meridian in Chinese Medicine

  11. The Function of Kidney Meridian • To Store Essence • Dominate Human Reproduction & Development • Dominate Water Metabolism & Reception of Qi • Produce Marrow to Fill Up the Brain • Dominate Bone • Manufacture Blood • Manifest in the Hair • Open into the Ear • Dominate Anterior and Posterior Orifices …Chinese Acupuncture & Moxibustion

  12. Clinical Applications of Acupuncture for Patients with Kidney Cancer Post Surgical (Removing of the Kidney) • Pain • Cryosurgery • Radiofrequency Ablation • Nausea • Loss of Appetite • Constipation

  13. Clinical Applications of Acupuncture for Patients with Kidney Cancer Side Effects Related to Target Therapy • Mucositis • Diarrhea • High Blood Pressure • Anemia • Nausea • Vomiting Radiotherapy Induced Symptoms • Skin Irritation

  14. Other Symptoms as a Result of Biological Therapy • Insomnia • Skin Reaction (rash or swelling • Headache • Muscle Ache • Fatigue • Mood Disorder • Feeling a Loss of Control • Loss of Appetite

  15. Risk of Harm Associated with Non-Conventional Approaches to Cancer Management • Symptom control of pain, blood in the urine, should be initiated after underlying causes have been identified • Claims to “cure” cancer with natural and non-toxic treatment • Herb-drug interactions • Side effects associated with unsafe and unregulated non-conventional interventions

  16. Requirements for Acupuncturists Working with Oncology patients • Acupuncture License • National (optional) • State (required) • General Medical Training Background • Hospital System Experience • Good Communication Skills • Experience Treating Oncology Patients

  17. Chinese Herbal Medicine to Support Patients Going Through Chemo and Radiation Bu Zhong Yi Qi Tang Ren Shen Ginseng Rx. Bai Zhu Atractylodis Alba Rz Huang Qi Astragali Rx Dang Gui Angelicae Sinensis Rx Dao Zao Jujubae Fr. Chen Pi Citri Reticulatae Pc. Chai Hu Bupleuri Rx. Zhi Gan Cao Glycyrrhizae Rx. Preparata Sheng Jiang Zingiberis Recens Rz Sheng Ma Cimicifugae Rz.. Energy Support Huang Qi Radix AstragaliRen Shen Radix Ginseng Ling Zhi Ganoderma Xi Yang Shen Radix Panacisquinquefolii Mu Dan Pi Cortex Moutan Zhi Mu Radix Anemarrhenae Fu Ling Poria Chen Pi Pericarpium Citri reticulatae Mai Men Dong Radix Ophiopogonis Dang Gui Radix Angelicae sinensis Ban Xia Rhizoma Pinelliae Preparatum Lu Gen Rhizoma Phragmitis Nu Zhen Zi FructusLigustrilucidiShaRenFructusAmomi Huang Jing Rhizoma Polygonati Gan Cao Radix Glycyrrhizae uralensis Radio Support Huang Qi Radix Astragali Dang Gui Radix Angelicae sinsis Hong Hua Flos Carthami tinctorii Dan Shen Radix Salviae miltiorrhizae Shou Wu Radix Polygoni multiflori preparata Gou Qi Zi Fructus Lycii chinensis Wu Wei Zi Fructus Schisandrae Nu Zhen Zi FructusLigustrilucidi Zhi Mu Radix Anemarrhenae Mu Dan Pi Cortex Moutan Gan Cao Radix Glycyrrhizae uralensis Sheng Di Huang Radix Rehmanniae Chen Pi Pericarpium Citri reticulatae Yu Zhu Rhizoma Polygonati odorati Formulas Nourish the Root Strengthen the Root

  18. BaZheng San with elements ofBai She Liu Wei Wan • Bai maoteng (solanumlyratum) • She mei (duchesneaindica) • Long kui (solanumnigrum) • Bai mao gen (impertacylindricarhizone) • Xian he cao (agrimoniapilosa var.) • Zhu ling (polyporus-grifola) • Fu ling (poriacocos) • Bianxu (polygonumaviculare) • Shan dou gen (sophoratonkinensis) • Dan shen (salvia miltiorhiza root) • Jin qiancao (lysimachia) • San qi (panaxnotoginseng) • Dang gui (angelica sinensis) • Tong cao (tetrapanaxpapyriferus)

  19. Liu weidi huang • Sheng di huang (rehmannia) • Shan zhuyu (cornusofficinalis) • Tu fu ling (smilax glabra) • Mu dan pi (paeoniasuffruticosa) • Bai mao gen (imperatacylindrica) • Xian he cao (agrimoniapilosa var. • Shan dou gen (sophoratonkinensis) • Bai mao ten (solanumlyratum) • Long kui (solanumnigrum) • She mei (duchesneaindica) • Dan shen (sulviamiltiorhiza) • Dan gui (angelica sinensis) • Jiang huang (curcuma longa) • Nu zhenzi (ligustrumlucidu) • Han liancao (ecliptaprostrata) • Yi ren (coixlacryma-jobi) • Huang qi (astragalusmembranaceus) • Sheng ma (cimicifuga)

  20. Analysis of Individual Herbsin Energy SupportPharmacology of Chemo Support Ingredients Huang Qi - Radix Astragali Membranacei • Enhancement of Immune Function The decoction given to mice increases the phagocytic activity of the reticuloendothelial system. • Antibacterial Effect In vitro was effective against Shigella Shigae, Bacillum anthracis, Streptococcus hemolyticus, and Staphyloccus aureus. • Effect on endurance Decoction of Huang Qi given to mice significantly increase the endurance in swimming tests.

  21. Dang Shen - Radix Codonopsis pilosulae Promotion of Phagocytosis Daily administration of decoction enhanced reticuloendothelial phagocytosis Hematologic effect Oral and intravenous use of Dang Shen in normal rabbits caused an increase in red blood cell count and hemoglobin. Immunologic effect Dang Shen inhibited the febrile reaction to toxins such as turpentine in mice and rats. Anti-ulcerative effect Pre-treatment with the decoction of the herb reduced the incidence of ulcers in rats due to stress of pylorus ligation. Analysis of Individual Herbsin Chemo Support

  22. Analysis of Individual Herbsin Chemo Support Ling Zhi - Fructificatio Ganodermae lucidi • Antimicrobial Action The decoction of the root showed strong antibacterial action in vitro against, Bacillus subtilis, Escherichia coli, Salmonella typhi, Staphylococcus aureus, Streptococcus hemolytic Fu Ling - Scierotium Poriae Cocus • Antineoplastic effect Produces an inhibition rate of 96.88% against sarcoma in rats. • Effect on Immune Function Oral administration increased phytohemagglutinin-induced lymphocyte transformation rate and increased serum IgG.

  23. Analysis of Individual Herbsin Chemo Support Chen Pi- Pericarpium Citri reticulatae • Actions on gastro-intestinal smooth muscles The herb decoction inhibited the motility of isolated small intestines of mice and rabbits. Dang Gui- Radix Angelicae sinesis • Effect on platelet aggregation Inhibited rat platelet aggregation and serotonin release Ban Xia- Rhizoma Pinelliae ternatae • Anti-emetic action Prevents early vomiting caused by deslanoside as well as emesis caused by orally-administered copper sulfate.

  24. Current Research on Alternative Therapies Cohen, Lorenze and Markman, Maurie. Integrative Oncology. p 126. Huston, TX. 2008 Humana Press.

  25. Bibliography • Maciocia, Giovanni, The Three Treasures Newsletters Autumn, 1999 • Perry M, Anderson C, Dorr V, Wilkes J, The Chemotherapy Sourcebook, Williams & Wilkins, Baltimore, Maryland, 1999. • Skeel R, Handbook of Cancer Chemotherapy, Williams & Wilkins, Baltimore, Maryland, 1999 • Zhu YP, Chinese Materia Medica, Harwood Academic Publishers, Amsterdam, 1998. • Bensky D and Gamble A, Chinese Herbal Medicine Materia Medica, Eastland Press, Seattle, 1993. • Chang H.M. and But P.P. Hay, Pharmacology and Applications of Chinese Materia Medica, World Scientific, Hong Kong, Vol. I, 1986., World Scientific, Hong Kong, Vol. I, 1986. • Dorsher PT, “The Neuroanatomic Basis of the Acupuncture Principal Meridians”, Mayo Foundation for Medical Education and Research 2009 • Harris RE et al.“Traditional Chinese acupuncture and placebo (sham) acupuncture are differentiated by their effects on µ-opiod receptors (MORs)”, Elsevier Inc. 2009 • Cohen, Lorenze and Markman, Maurie. Integrative Oncology. p126. Huston, TX. 2008 Humana Press. • Kathleen K.S.Hui, Jing Liu, Niko Makris, Randy L. Gollub, Anthony J.W. Chen, Christopher I. Moore, David N. Kennedy, Bruce R.Rosen, and Kenneth K. Kwong. “Acupuncture Modulates the Limbic System and Subcortical Gray Structures of the Human Brain: Evidence From fMRI Studies in Normal Subjects”, Massachusetts, 2000 • Andrew B . Newberg MD, Patrick J. LaRiccia, MD Brunde Y. Lee, MD, John T. Farrar, MD, Lorna Lee, MA, Abass Alavi, MD. “Cerebral Blood Flow Effects of Pain and Acupuncture: A preliminary Single-Photon Emission Computed Tomography Imagining Study.” American Society of Neuroimaging. 2004 • Lahans, Tai, ‘Integrating Conventional and Chinese Medicine in Cancer Care’ 2007 • Deng Liangyue, et al. “Chinese Acupuncture and Moxibustion” 1987 • Gabriela E. Garcia, Sheng-Xing Ma, and LiliFeng “Acupuncture and Kidney Disease” Advances in Chronic Kidney Disease, Vol 12, No 3 (July), 2005: pp 282-291

  26. Medicine today is science, and business, and law (perhaps not in that order) but not so much art as it seemed to be even when I started. I know why we are counting, why it is important, essential even. Despite years of study and numbering, after all, we still haven’t settled the role of vitamins, hydrochlorothiazide, mammograms, aspirin, diabetes control, or almost any other topic in medicine including statistical analysis itself. But medicine as its fundamental is still about suffering, healing, and comforting; it is about individuals; it is about relationships, and trust; it is about stories. Michael H. Monroe, MD.Drawer on the Right. Charlotte, North Carolina, March 23/30, 2011 JAMA

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