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Lung Cancer : Treatment
Western Medicine
Chinese Medicine
The treatment chosen depends on the type of lung cancer (See definition section), whether or not it has spread to other parts of the lungs and body and what kind of symptoms it is causing. Other factors, like the general health of the person and his or her ability to withstand major surgery also affect treatment choices. For example, many smokers have very poor lung function making them a high surgical risk.

Surgery is usually only performed if it is believed the tumour can be completely removed. Small cell carcinomas respond much better to chemotherapy than surgery so these tend not to be surgically removed. People with non-small cell cancers deemed suitable, that is those found early, before they have spread beyond the lungs, have about a 70 per cent survival rate. If the tumour has begun to spread but the spread is only within the chest, it may still be surgically removed but the patient will be offered a combination of radiotherapy and chemotherapy as well (see below). Less than 50 percent of people with this degree of lung cancer are expected to survive.

Sometimes surgery is done on individuals with extensive cancer if it is blocking the airways and causing distressing symptoms such as difficulty breathing.

Surgery usually involves removing a portion of the lung and the lymph nodes to which the cancer is expected to spread first. This is called a lobectomy. Sometimes if surgeons are confident that a tumour will be cleared by removing a whole lung, they will perform a procedure called a pneumonectomy.

Radiotherapy: If the cancer has spread and the cells are of a type considered "radio-sensitive," that is they are likely to be destroyed by radiation therapy, an intense beam of radiation will be aimed at the tumour area in a series of doses given over a few weeks. This may also be given to people who have had surgery in order to kill any cancer cells or tiny tumours that may have escaped surgical removal.

Radiation therapy is most commonly used in lung cancer to control the symptoms of the disease rather than cure it. It can slow or stop the growth of the known tumour but usually does not stop it from spreading elsewhere. Radiation therapy may also be used to control pain caused by its spread to other places, especially the bones.

Because radiation therapy is not specific to cancer cells, it can destroy many types of cells including blood cells, bowel cells and liver cells. Therefore, it has to be used sparingly and carefully. Even so, many people receiving radiation suffer side effects such as lowered blood cell numbers, infections, fatigue, nausea, vomiting and diarrhea.

Chemotherapy: When the cancer is thought to have spread beyond the lung, or the cells are of a type known to be easily destroyed by particular chemicals, chemotherapy, which uses chemicals highly toxic to cancer cells, is usually given in a series of doses through an intravenous (IV) catheter. Chemotherapy is usually the first choice of treatment for small cell cancers as they respond best to this kind of therapy, especially if the cancer is detected early. Like radiotherapy, chemotherapy has serious side effects because the chemicals are also toxic to normal cells. Rapidly dividing cells, such as red blood cells, immune system cells and liver cells, are affected and may take a long time to recover their normal functions. A number of cancer treatment centres are testing Traditional Chinese Medicine formulas known to boost the immune system to help cancer patients cope with the side effects of chemotherapy.

Palliative care: When a cure is no longer considered possible, treatment will center on relieving pain and other distressing symptoms. Pain relief with opiates, including self-administered intravenous morphine pumps, physiotherapy, massage, hypnotherapy, family support and counselling, Traditional Chinese Medicine formulae may all be offered to help control symptoms. Some people enter a hospice to spend their last days while others may opt to stay at home to be close to their loved ones.

Treatment of lung cancer is complex and can benefit from a complementary western and TCM approach. Often the combined treatment of western medicine and TCM produces better outcomes than using either method alone.

A lot of traditional TCM treatments increase the body's resistance to invading pathogens (substances that cause disease) in order in to increase a person's lifespan. TCM treatments aim to relieve symptoms, stop the disease's progression and restore healthy functioning of the individual rather than curing (in the western sense) a disease completely. While herbs are commonly used, other methods of treatment may include acupuncture, meditation and qi gong.

Recently, with the advances in western research techniques, there has been a lot of research into anticancer mechanisms of Chinese herbs. Studies have shown that certain TCM herbs can work in the following ways to help slow down or stop the progression of cancer by:

1. Inducing the cancer cell to differentiate into a normal cell.
2.. Promoting apoptosis of cancer cells. Apoptosis, also sometimes called programmed cell death, means that a chemical signal is triggered within the cell telling it to die. In cancer cells this chemical signal seems to be turned off, which is why they multiply rapidly.
3. Helping to block the chemical messages in cancer cells that tell them to grow, multiply and form into tumours.
4. Improving the efficacy of chemotherapy. Currently many cancers are developing drug resistance to chemotherapy regimens because of their high expression of P-polysaccharides(PGP). Some TCM herbs can interfere with this expression or offer new ways to attack cancer cells.
5. Activating blood circulation and eliminating blood stasis. It is thought better blood circulation can limit the tumour spread and allow chemotherapy to reach the cancer cells more effectively.
6. Supporting the body's own immune system by activating macrophages, increasing antibody production, and regulating lymphocytes so it can fight cancer cells more efficiently and limit the growth of the tumor. Some mushrooms such as yunzhi (Coriolus versicolor) and lingzhi (Ganoderma lucidum) are known for their ability to support healthy immune system function.
7. Killing the cancer cells directly.

Because there are many, TCM prescriptions and products that may possess one or more of the above properties, it is best to get the advice of a TCM practitioner who knows what's best for you and your condition.

The treatments described below are some approaches that may be taken to treat the different TCM syndromes associated with lung cancer.

1. Yin Deficiency and Interior Heat Syndrome
Therapeutic aim: Nourish yin and clear away lung-heat, soften the hard mass found in the chest and remove toxins from the body.

Prescription: Yangyin Qingfei Xiaojie Tang Jiajian Decoction.

Nanshashen Fourleaf Ladybell Root
Beishashen Coastal Glehnia Root
Tiandong Cochinchinese Asparagus Root
Maidong Dwarf Lilyturf Tuber
Baihe Lily Bulb
Xingren Almond
Baibu Stemona Root
Yuxingcao Heartleaf Houtuynia Herb
Shengyiren Raw Coix Seed
Quangualou Whole Snakegourd Fruit
Bayuezha Akebia fruit
Shishangbai Selaginella Herb
Shijianchuan Chinese Sage Herb
Baihausheshecao Hedyotis Diffusa Herb
Chanpi Dry skin of Toad
Xiakucao Spike of Prunella
Shenmuli Raw Oyster Shell

Addition for individuals with sputum mixed with blood:

Xianhecao Hairyvein Agrimonia Herb
Baimaogen Lalang Grass Rhizome

Addition for individuals with low grade fever:

Yinchaihu Starwort Root
Digupi Chinese Wolfberry Root-bark

Addition for individuals with insomnia:

Zaoren Date Seed
Hehuanpi Silktree Albizia Bark
YeJiaoteng Fleece-flower Stem

Addition for individuals with night sweating:

Rudaogen Glutinous Root
Fuxiaomai Blightened Wheat

2. Spleen Deficiency and Phlegm Dampness Syndrome
Therapeutic aim: Replenish qi and invigorate the spleen, disperse lung-qi and help break up and expel phlegm.

Dangshen Tangshen
Baizhu Largehead Atractylodes Rhizome
Fuling Indian Bread
Chenpi Dried Tangerine Peel
Banxia Pinellia Tuber
Xingren Almond
ShengnanXing Rhizome of Arisaema
Shanhailuo Codonopsitis Root
Shishangbai Selaginella Herb
Shijianchuan Chinese Sage Herb
Yiren Coix Seed
Ziwan Tatarian Aster Root
Kuandong Common Coltsfoot
Jiaoshanzha Hawthorn Fruit (charred)
Jiaoshenqu Leavened mixture of almond, sweet wormwood herb etc.(charred)

Addition for individuals with an abundant expectoration of sputum

Baijiezi Seed of Sinapis Alba
Tianjiangke Shell of Metaplexis fruit

Addition for individuals with loose stool and cold limbs

Buguzhi Malaytea Scurfpea Fruit
Huluba Common Fenugreek Seed
Tusizi Dodder Seed

3. Deficiency of Qi and Yin Syndrome
Therapeutic aim: Supplement qi, nourish yin, break up and expel phlegm and remove toxic substances from the body.

Prescription: Combination decoction of Sijunzi Tang and Shashen Maidong Tang Jiajian

Huangqi Raw Milkvetch Root
Baizhu Raw Largehead Atractylodes Rhizome
Beishashen Coastal Glehnia Root
Tiandong Cochinchinese Asparagus Root
Maidong Dwarf Lilyturf Tuber
Wuweizi Chinese Magnoliavine Fruit
Xingren Almond
Baibu Stemona Root
Gualoupi Snakegourd Fruit peel
ShengnanXing Rhizome of Arisaema
Shijianchuan Chinese Sage Herb
Baihausheshecao Hedyotis Diffusa Herb
Xiakucao Spike of Prunella
Shengmuli Raw Oyster Shell
Chuanbeimu Tendrilleaf Fritilary Bulb

Addition for individuals with yellow sputum

Huangqin Baical Skullcap Root
Sangbaipi White Mulbery Root-bark
Yeqiaomaigen Wild Buckwheat Root

Addition for individuals with more yin deficiency

Xiyangshen American Ginseng
Nuzhenzi Glossy Privet Fruit

Addition for individuals with more Qi deficiency

Shengshaishen Sun-dried ginseng
Taizishen Heterophylly Falsestarwort Root

4. Deficiency of Yin and Yang Syndrome
Therapeutic aim: Nourish yin, warm the kidney, subdue swelling and dissolve lumps or masses.

Prescription: Shashen Maidong Tang Decoction and Zan Yu Dan (fertility promoting pill)

Beishashen Coastal Glehnia Root
Tiandong Cochinchinese Asparagus Root
Shengdi Rehmannia Root (unprocessed)
Xianmao Common Curculigo Rhizome
Xianlingbi Epimeddium
Congrong Cistanche Deserticola Stem
Chuanbeimu Tendrilleaf Fritilary Bulb
Shoudi Rehmannia Root (processed)
Shandougen Vietnamese Sophora Root
Shishangbai Selaginella Herb
Huangbuliuxing Cowherb seed
Shijianchuan Chinese Sage Herb
Furongye Cottonrose Hibicus leaf
Xueliguo Climbing Fig Fruit

Addition for individuals with an aversion to cold and who have cold limbs

Fuzi Prepared Common Monkshood Daughter Root

Addition for individuals with frequent urination at night

Yizhiyen Sharpleaf Glangal Fruit Seed

Addition for individuals with difficult and fast breathing

Shengesan Powder of Ginseng and Gecko
Zishiying Fluorite
Tusizi Dodder Seed

5. Stagnation of Qi and Blood Stasis Syndrome
Therapeutic aim: Replenish Qi to resolve blood stasis, soften hard mass and dissolve lumps or masses.

Prescription: Fuyuan Huoxue Tang Jiajian Decoction (for recuperation and promoting blood circulation)

Taoyen Peach seed
Huangbuliuxing Cowherb seed
Danshen Danshen Root
Sanleng Common Burreed Tuber
Ezhu Zedoray Rhizome
fengfang Honeycomb
Bayuezha Akebia fruit
Chuanyujin Curcuma stem
Quangualou Whole Snakegourd Fruit
Shengbiejia Raw Turtle Shell
Xiakucao Spike of Prunella
Haizao Seaweed
Kunbu Tangle
Shandougen Vietnamese Sophora Root
Shijianchuan Chinese Sage Herb
Baihausheshecao Hedyotis Diffusa Herb
Shancigu Common Pleione Pseudobulb
Shengmuli Raw Oyster Shell

For individuals with bloodstained sputum

Taoyen Peach seed
Danshen Danshen root
Huangbuliuxing Cowherb seed
And Add:
Xianhecao Hairyvein Agrimonia Herb
Qiancaogen India Madder Root
Shensanqi Radix Notoginseng

Addition for individuals with a puffy face and head

ShengHuangqi Raw Milkvetch Root
Fangji Fourstamen Stephania Root
Cheqianzi Plantain Seed

Addition for individuals with severe pain

Yanhu Yanhu
Ruxiang Frankincense
Moyao Myrrh
Xuchangqing Paniculate Swallowwort Root