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Colorectal Cancer : Treatment
   
Western Medicine
Chinese Medicine

Surgery is considered the primary treatment for both colon and rectal cancers. Chemotherapy and radiation therapy are often used to treat colon and rectal cancers. The stage or extent of spread of the cancer will influence the treatment options for a patient with colorectal cancer.

Surgery

For both colon and rectal cancer, surgery is performed to remove all cancerous tissues while trying to retain as much function of the colon and rectum as possible. During surgery the surgeon will remove the part of the colon or rectum which contained the cancerous tissue and a small amount of normal healthy tissue surrounding the cancerous tissue. Lymph nodes near the cancerous tissue are often times removed as well. These lymph nodes will be analyzed to determine if any cancer had spread to them. The healthy parts of the colon or rectum will be reconnected. If the surgeon can not reconnect the healthy portions of the colon or rectum, a colostomy will be created. A colostomy is an opening in the abdomen that allows feces to pass through. A bag is placed over the opening to collect the feces. Sometimes patient may have a temporary colostomy, in which a colostomy is created to allow the healthy tissue to heal, after which time the patient's colon or rectum is reconnected and the colostomy is removed. After the colostomy is removed the patient passes feces through their anus. Surgery can be curative for early-stage colorectal cancer.

A colostomy is an opening in the abdomen that allows feces to pass through.

 

Chemotherapy

Depending on the extent or stage of the cancer at the time of initial diagnosis, chemotherapy may be given before or after surgery. When chemotherapy is given after surgery to kill any remaining cancer cells or to prevent the spread of cancer cell it is referred as adjuvant therapy. There are several chemotherapy drugs that are used for colorectal cancer. Some are given as adjuvant therapy while others are used if the cancer returns or spreads to other organs. Chemotherapy for colorectal cancers can be given through the veins into the blood or be taken by mouth.

Unfortunately, when chemotherapy is given through the veins into the blood or taken by mouth, healthy cells as well as cancer cells are affected. Most side effects of chemotherapy are a result of the healthy cells being affected by the chemotherapy. Common side effects of chemotherapy medications that are used to treat colorectal cancer include, mouth sores, diarrhea, and low blood counts.

If the cancer has spread to the liver, chemotherapy medications can be injected into one of the blood vessels going directly to the liver. This type of chemotherapy can decrease the occurrence of side effects that one would experience if the same medication was given into a vein. However this type of chemotherapy administration will not treat cancer that has spread to organs other than the liver.

Radiation therapy

Radiation therapy is not routinely used for the adjuvant treatment of colon cancer. However, it is used for rectal cancer. Radiation therapy may be given before or after surgery to patients with rectal cancer depending on the extent or spread of the cancer at the time of diagnosis. The goal of radiation therapy is to use high-energy rays to damage cancer cells and to stop them from growing. The radiation therapy only affects the tissue and cells that are exposed to the high energy rays. Side effects of radiation therapy include diarrhea, low blood counts, skin irritation, and fatigue.


 

Various TCM therapies can be used at any stage of the disease or in combination with Western treatment at any time. Individuals can benefit from its preventative effects, improve their quality of life or boost the immune system, relieve or eliminate adverse effects caused by chemotherapy, and even help in the palliative care of terminal cancer patients. The following methods are for general information only; a qualified physician should always be consulted for treatment options. Self-treatment is not recommended.

Treatment based on TCM differential diagnosis

Physicians select the treatment method according to TCM differential diagnosis, the "disharmony patterns" made by analyzing the collected data. All these remedies are adjusted to suit specific individual conditions.

Downward migration of damp-heat
Therapeutic aim:
to clear away heat in order to drain dampness. Commonly used prescriptions are huaihua diyu tang, qingchang yin, or baitouweng tang.

Sample prescription:
baitouweng tang
(白頭翁湯)
bai tou weng Root of Chinese Pulsatilla
huang lian Rhizome of Chinese Goldhread
huang bai Bark of Chinese Corktree
qin pi Chinese Ash Bark

Excessive accumulation of poisonous pathogens
Therapeutic aim: to clear away heat to cool blood, remove stasis, and detoxify the body. Commonly used prescriptions are wuwei xiaodu yi and huanglian jiedu tang.

Sample prescription: huanglian jiedu tang (黃連解毒湯)
huang lian Rhizome of Chinese Goldhread
huang qin Root of Baikal Skullcap
huang bai Bark of Chinese Corktree
zhi zi Fruit of Cape Jasmine

Interior retention of blood stasis
Therapeutic aim: to clear away heat to cool blood, remove stasis, and detoxify the body. Commonly used prescriptions are wuwei xiaodu yi and huanglian jiedu tang.

Sample prescription:
xiefu zhuyu tang (血府逐瘀湯)
dang gui Chinese Angelica Root
sheng di Dried Rehmannia Root
tao ren Peach Seed
hong hua Safflower Flower
zhi ke Bitter Orange
chi zhao Common Peony Root
niu xi Twotooth Achyranthes Root
jie geng Balloonflower Root
chuan xiong Szechuan Lovage
chai hu Chinese Tororwax Root
gan cao Liquorice Root

Deficiency in vital energy (qi) and blood
Therapeutic aim: to replenish qi and nourish the blood. Commonly used prescriptions are guipi tang and bazhen tang.

Sample prescription:
guipi tang (歸脾湯)
bai shu Large Head Atractylodes Root
fu ling Indian Bread
huang qi Mongolian Milkvetch Root
long yan rou Logan Aril
suan zao ren Spine Date Seed
ren shen Ginseng Root
mu xiang Root of Common Aucklandia
zhi gan cao Liquorice Root (processed with honey)
dang gui Chinese Angelica
yuan zhi Root of Thinleaf Milkwort
sheng jiang Rhizome of Common Ginger
da zao Common Jujube Fruit

Yang deficiency in spleen and kidney
Therapeutic aim: to warm and tonify the spleen and kidneys. Commonly used prescriptions are zhenling baishu san and sishen wan.

Sample prescription: shenling baishu san (參苓白術散)
ren shen Ginseng Root
fu ling Indian Bread
bai shu Large Head Atractylodes Root
bai bian dou White Hyacinth Bean
huai shan Chinese Yam
lian zi Seed of Hindu Lotus
sha ren Fruit of Villous Amomum
yi yi ren Seed of Job's Tears
jie geng Balloonflower Root
gan cao Liquorice Root

Yin deficiency in liver and kidney
Therapeutic aim: to nourish and tonify the liver and kidney. A commonly used prescription is zhibai dihuang wan.

S
ample prescription: zhibai dihuang wan (知柏地黃丸)
shu di Processed Rhemannia Root
shan yu rou Asiatic Cornelian Cherry Fruit
huai shan Chinese Yam
dan pi Tree Peony Bark
fu ling Indian Bread
ze xie Oriental Water-plantain Root
zhi mu Common Anemarrhena Rhizome
huang bai Bark of Chinese Corktree

External Treatment

Treatments other than the oral drugs include acupuncture, plasters, sauna, and massage. These methods are commonly applied to localized lesions according to the presentation of symptoms.

Acupuncture
To relieve pain and vomiting, selected acu-points are:
zu-san-li, tian-shu, he-gu, xia-ju-xu, nei-guan, and da-chang-shu.

Samples of acu-points that helps to relieve pain and vomiting.

Moxibustion
This is suitable for colorectal cancer patients who have complications such as ascites (free fluid accumulating in the abdominal cavity). Selected acu-points are:
tian-shu, zhong-wan, xia-wan, guan-yuan, shen-quel.
Recommended treatment is 2-3 times daily.

Topical application of drugs
This refers to local application of pounded fresh medicinal herbs or moisturized medicinal powder over the affected part. They are applicable for local infections, ulcers, swelling, pain and injuries. In this case, individuals can apply to relieve pain caused by cancer, e.g. toad paste.

Application of TCM plaster for topical use.



Enema
This refers to the introduction of a liquid into the bowel via the rectum, to be either expelled or retained. It is suitable for individuals with bloody stools. For example, a TCM decoction is prepared using the bark of Chinese Corktree (huang bai), root of Baikal Skullcap (huang qin), root of Redroot Growwell (zi cao), rhizome of Japanese Fleeceflower (hu zhang), common Picria herb (ku shen), and fruit of Japanese Apricot (wu mei).

TCM patent drugs or simple folk remedies

TCM has many patent drugs or simple folk remedies for relief of symptoms. Physicians usually prescribe these to complement other treatments.

Qi-gong

This method is beneficial for regulating the body and mind, strengthening the constitution, and relieving the adverse effects of radiotherapy or chemotherapy. Patients select relevant exercises in consultation with their physician. A desirable result can only be achieved by long-term and persistent practice.

For example:

  • First prepare by adopting a half standing and half sitting posture; hold the arms tight at the side with the each hand in a fist; the two feet are a shoulder's width apart and the eyes are slightly closed.

    Slowly start to inhale, grab the ground with the toes, contract the groin area, and lift up the anus.

    Concentrate on making the breath (qi) sink down to the dantian (3 cm below the navel); let your mind control the qi circulating throughout the body; then exhale and relax. Say to yourself that qigong can cure cancer and let the hands and feet wave freely.

  • Practice this every morning and night.
"Standing posture" usually seen at the beginning of qi-gong practice.