Western Medicine

normal lung

Lung cancer is the most commonly fatal of all cancers, killing more than half a million people worldwide every year. A majority of lung cancers are linked to tobacco use. As this habit becomes more prevalent, lung cancer numbers rise. It is the leading fatal cancer among adult males and is rapidly increasing in women, as more and more take up smoking.

Lung cancer develops when lung cells change into abnormal cancer cells after being continually irritated by something in their environment, known as a carcinogen. The most common lung carcinogens are the toxins in cigarette smoke, to which both smokers and those breathing other people's secondhand smoke are exposed. The Cancer Society of New Zealand reports that second-hand smoke is the third largest killer in the country, after active smoking and alcohol use. Industrial chemicals and dusts can also act as carcinogens and contribute to the development of lung cancer.

Cancer cells are cells able to divide very rapidly and do not follow the regular patterns of normal healthy cells. They form colonies or tumours of tissue that do not help the lungs to function normally. Some cancer cells break off and travel in the blood to different parts of the body to form new cancer colonies known as "metastases." When these cancer colonies grow so large that they interfere with normal lung function or the healthy functioning of other parts of the body, symptoms like pain, bleeding, loss of function (i.e. difficulty breathing), and /or weight loss may appear.

Types of Lung Cancer
Lung cancers are grouped according to the type of cells they contain. Because each cancer cell type behaves differently, selected treatment will also be different.

• Squamous cell carcinoma is the most common type of lung cancer (30 percent of cases) and is almost always associated with tobacco smoking. It develops in the lung cells lining the main bronchi (the largest air passages). This tumour often grows out into the airway and blocks it, leading to symptoms like breathlessness, chronic cough, and bloodstained (rusty) sputum. It usually spreads into the chest wall and local lymph nodes before metastasizing (sending cancerous cells to distant parts of the body). When this happens, it may be discovered and diagnosed early enough for effective surgical removal.
• Adenocarcinoma is the form of lung cancer most commonly found in non-smokers and accounts for 29 percent of all lung cancers. There is a high rate of this kind of cancer among non-smoking Hong Kong women. It develops in the glands supplying the lungs with mucous of the airways and is often found in the outer areas of the lung.
• Small cell carcinoma, another common cancer, (17 percent of lung cancer cases), is also strongly linked to cigarette smoking. This type is sometimes referred to as oat cell carcinoma because the cancer cells look oat-shaped. Small cell carcinoma can cause a rapid early death because it spreads or metastasizes quickly and is "silent," meaning it does not have early warning symptoms.
• Large cell carcinoma is responsible for 15 percent of lung cancer cases. It has large, rounded cells and grows in the airways eventually making it difficult to breathe.
• Bronchioloalveolar cell carcinoma is a rare tumour found in less than two percent of cases.
• Unknown cell types: Nine percent of tumours contain cancer cells which pathologists cannot identify or classify either because the cells are "mixed" (containing a range of different types of cells), undifferentiated (do not have characteristics belonging to any particular cell line) or come from another part of the body.
• Mesothelioma is not always classified as lung cancer because it develops in the membranes (pleura) covering the lung and the inside of the chest walls. A rare tumour, mesothelioma is strongly linked with exposure to asbestos. This is the reason asbestos is now considered to be a very dangerous material.

Chinese Medicine

According to Traditional Chinese Medicine (TCM) theory, lung cancer is included under the categories describing "lung-masses", "expanding-masses", "cough", "cough blood" and "chest pain". Several ancient medical books make reference to it. For example, in the book "Summary from the Golden Chest " (Han Dynasty 206-220AD) under the five organs section, it states "the [lung] mass cannot be easily removed." In the Huang Di Nei Jing Su Wen , another famous book written during the Han dynasty, it refers to "difficulty breathing [with lung cancer] without having difficulty eating." TCM believes lung cancer results from having a lack of healthy energy and from the accumulation of exogenous evils (outside influences that invade the body and cause illness).

Western Medicine

• Tobacco smoking causes more than 75% of lung cancer cases. Some researchers put that figure as high as 95 percent. People who started smoking as teenagers have the greatest risk of developing lung cancer. Lung cancer is most commonly seen in adults aged 40-70 who have smoked cigarettes for about 20 years.
• Second-hand tobacco smoke, which is the smoke breathed in by people sharing an indoor environment with smokers, also called environmental tobacco smoke, is believed to contribute to the development of lung cancer. Children exposed to second-hand smoke are thought to be particularly in danger of developing a variety of respiratory diseases, including lung cancer, later in life.
• Occupational exposure to asbestos is associated with a particular type of lung cancer called mesothelioma. Other occupational exposures associated with lung cancer include contact with the processing of steel, nickel, chrome and coal gas.
• Exposure to radiation raises the risk of developing cancers of all kinds, including lung cancer. In areas where radon gas levels are high, (i.e. Hong Kong), poor ventilation may lead to high exposure among people spending long hours indoors. Miners of uranium, fluorspar may also be exposed to radiation by breathing air contaminated with radon gas.
• Air pollution: The risk posed by air pollution and its possible links to lung cancer are controversial. There are more cases of lung cancer among city dwellers than among those living in rural areas, even after the effects of smoking are ruled out as the cause. However, because the components of air pollution are so complex and variable it is hard to prove whether or not air pollution causes lung cancer.

Chinese Medicine

Click here to see how lung cancer forms in
TCM.

Retention of Wetness and Phlegm evil Hypofunction (under functioning) of the spleen causes a disturbance in body-fluid metabolism and failure of fluid transportation, which are part of this organ's main functions in TCM. Untransformed body fluid turns into phlegm and wetness, which are toxic materials. These toxic materials flow upward and interfere lung function.

Stagnation of Vital Energy
Under normal conditions, the vital energy (qi) circulates smoothly in and out, up and down and all over the body. If an internal injury occurred, for example, depression of the seven emotions will cause deficiency and impairment of vital qi and derangement of yin and yang, it may cause breathing syndromes due to the improper lung function. TCM believes yin and yang disharmony is the cause of disease and physiological disorders. Disharmony means the proportions of yin and yang are unequal and unbalanced. When one aspect is deficient, the other is in excess. Lung cancer is induced by an overall deficiency of qi and yin in the body, which leads to an excess syndrome in the lungs. The excess syndrome generally manifests as pathological lung changes such as a stagnation of qi flow, blood stasis (lack of easy blood flow) and accumulation of phlegm and toxins.
Blood Stasis
Vital energy (qi) acts as the commander of blood. It means that vital energy is the motivating force of the blood circulation. Therefore blood stasis is usually accompanied by stagnation of vital energy. Coagulation and stagnation of qi and blood flow can contribute to the formation of a tumour.

Pathogenic evils (substances causing disease) invade the lung
When the healthy energy is deficient due to body dysfunction or structural damage. Some pathogenic evils such as wind and cold take advantage of this imbalance and invade the lung. Over time these evils accumulate in the lungs and can cause cancer.

How do these factors contribute to the development of lung cancer?
As a result of lung dysfunction and improper qi flow, body fluids cannot be properly distributed. They begin to accumulate in the lungs and eventually turn into phlegm. Over time, the phlegm, stagnant blood and qi flow, and the remaining toxins trapped in the lungs form into a lump, which would be known in western medicine as a lung cancer mass.

Other Factors Associated with the Development of Lung Cancer:

1. Smoking
2. Occupational Exposure to Carcinogens (substances that can cause cancer) i.e. inorganic arsenic, asbestos, chrome, nickel, radon, hydrocarbon in coal smoke, coal tar, and fossil oil
3. Air pollution
4. Ionizing Radiation
5. Diet and Nutrition

Western Medicine

Because the lungs are a large organ and lung cancers usually start off as very small tumours, many people experience only vague symptoms such as a chronic cold or cough. In some cases, lung cancers are picked up during a routine chest X-ray in people who have no idea they have a serious disease. When symptoms do appear, the most common symptom is a persistent cough that is not associated with another type of illness or a change in a chronic cough (particularly in smokers who usually have chronic coughs).

Common symptoms include:

• Chronic cough
• Hoarseness
• Coughing up blood or rusty-colored sputum
• Weight loss & loss of appetite
• Shortness of breath
• Fever for no obvious reason
• Wheezing
• Difficulty swallowing
• Chronic bronchitis and /or pneumonia that does not improve with the usual treatments

These features are seen in many other lung diseases so the only way to find out the cause is to undergo thorough investigation by a qualified healthcare provider.

Chinese Medicine

Lung cancer can be divided into 5 different syndromes. The symptoms will differ depending on the syndrome each individual has.

1. Yin Deficiency and Interior Heat Syndrome
Symptoms include a cough without sputum or a cough with thick sputum. The sputum can appear blood stained. Breathlessness, chest pain, a dry mouth and throat, a hoarse voice, mild fever and night sweats may also be present. Individuals may feel distracted or have insomnia. The tongue appears flushed or dark red and has a little or no coating. The pulse feels rapid and thready.

2. Spleen Deficiency and Phlegm Dampness Syndrome
Symptoms include a cough that produces a lot of sputum and chest tightness accompanied by shortness of breath. These individuals usually feel weak and fatigued and have pale complexions. Weight loss and loose stools are also common. Their tongues appear pale and bulging and have an indented margin. A white and greasy fur coating may also be present. The pulse feels soft and moderate or soft and rolling.

3. Deficiency of Qi and Yin Syndrome
Symptoms include a low and weak sounding cough, which produces a small amount of sputum, which can be bloodstained. These individuals can experience shortness of breath, fatigue and weakness. They are thirsty but lack the desire to drink and may sweat spontaneously or have night sweating. The tongue appears light red or red with an indented margin, and the pulse feels thready and weak.

4. Deficiency of Yin and Yang Syndrome
Respiratory symptoms include a cough, shortness of breath, dyspnea (difficulty breathing) and/or tachypnea (rapid breathing) with exercise. Tinnitus (ringing in the ears), body aches, lower back (lumbar) or knee weakness, urinary frequency at night may also be present. Individuals can have an aversion to cold and have cold limbs. General fatigue and weakness are also not uncommon. The tongue appears light or dark red with a thin fur coating, and the pulse feels deep and faint.

5. Stagnation of Qi and Blood Stasis Syndrome
Symptoms include difficulty coughing and expectorating bloodstained sputum, chest tightness, tachypnea (rapid breathing), chest pain and distension and abdomen pain located in a fixed position. Purple veins show on the neck and chest. Lips and nails are dark coloured. Constipation with dry and hard stools may also be present. The tongue appears dark red and may have either ecchymosis (bruise) or petechiae (pinpoint bruises) with a yellowish thin coating. The pulse will feel taut or uneven.

Western Medicine

History: Before starting any investigations, your health care provider will want a detailed medical and family history to help decide if you are at risk for developing lung cancer. Important information includes whether you are a smoker, live with a smoker, grew up with smoking parents or relatives, work in a smoky environment or are exposed to secondhand smoke frequently. Exposure to other hazards such as radiation, air pollution and asbestos are also significant pieces of information, because all these things will increase your chances of having lung cancer. Important family history includes whether any of your parents, aunts, uncles or brothers and sisters has or had cancer, especially lung cancer because there is a genetic element associated with cancer development. Other significant history details include what kind of symptoms you are experiencing, when they started, and how long they last.

If you have had close contact with anyone with tuberculosis or have been living in a place where tuberculosis is common you should tell your healthcare provider. Lung cancer and tuberculosis have very similar symptoms and can mimic each other but need to be treated very differently

Physical Examination:

Before doing any tests your healthcare provider will perform a physical examination looking for signs of weight loss and general debilitation. They will check the inside of the mouth, the tongue and the throat for signs of cancerous spread, infection or for other causes of the symptoms you are experiencing. Head and neck lymph nodes will be felt to see if there has been any cancerous spread there. The lymph nodes will feel stony and hard and be hard to move if they contain cancer. The liver will also be felt for any signs of cancer. If cancer has invaded the liver to a significant degree, it may feel hard and irregular.

Most importantly, the lungs are examined by percussion (tapping the back) and auscultation (listening with a stethoscope). This is done to look for signs of obstruction, which will make breath sounds reduced or may cause a wheeze; of congestion, which can cause wheezing, altered or reduced breath sounds); and of fluid in the lining of the lungs, which makes the lung areas sound dull when tapped and breath sounds reduced.

Investigations:

After a thorough history and physical examination, your healthcare provider may order one or more of the following tests to confirm the diagnosis and determine the type of lung cancer:

Sputum cytology: Sputum (phlegm) coughed up over a few days is collected and examined under a microscope for cell identification. The cells, (which can be blood cells, skin cells, cells lining the airways, different types of lung cells and bacterial cells), will be carefully checked for signs of cancer or evidence of other diseases causing the symptoms.

Chest X-ray: An x-ray picture of the chest can reveal a lung tumour larger than one centimetre and gives an idea of its location but will not indicate what type of tumour it is.

Blood screening tests: These are done to assess the general health of the person suspected of having lung cancer, especially when determining his or her fitness for surgery if a tumour suitable for surgical removal is found.

CT scan (computed tomography): This is a more complex form of x-ray where a series of pictures like slices through the body are taken and put together by a computer to give a detailed picture of the area being examined. This method can detect tumours smaller than one centimetre and give a more exact picture of the location and possible spread of the cancer.

MRI scan (magnetic resonance imaging): Another even more advanced form of imaging done to give more detail of the tumour and surrounding tissues.

Bronchoscopy: Once a suspected tumour has been located by an x-ray, CT scan or MRI, a bronchoscopy may be performed. A flexible tube with a tiny telescope on the end is passed down through the nose and throat and into the bronchi (the main air passages) to search for the tumour. Once a possible tumour is located, a biopsy-where a tiny piece of tissue is cut off-will be performed so a pathologist can examine the cells.

Chinese Medicine

Development of lung cancer comes from a weakening of the healthy energy that flows through the body. As previously stated, this mainly occurs when there is a deficiency of vital qi and imbalance of yin and yang. It manifests itself as one of the five syndromes previously described under the "symptoms" section.
Diagnosis in TCM is based on four important examination techniques. The first is "questioning." The TCM practitioner will want to know important information such as what your current complaints are, your past medical history, and family health history. The second technique is "observation." Looking at the physical features of the body such as the face, tongue, hair, nails, sputum and area of pain all give clues as to what the problem may be. The third technique is "hearing and smelling." Smelling the sputum and breath and listening to the sounds coming from the chest are important when evaluating lung cancer. The last technique used in examination includes "touching." Feeling the pulse is one of the cornerstones of TCM diagnosis and gives the TCM practitioner a lot of information about the imbalance occurring in the body.
If the TCM practitioner, suspects there might be a serious problem that Chinese medicine alone cannot treat, he or she may recommend that the individual see a western doctor for further follow up. It is also not uncommon for a TCM practitioner to ask to see the blood work or x-rays that you have had performed to give the practitioner more information when forming a TCM diagnosis. The syndromes that are most commonly diagnosed with lung cancer include:

1.
Yin Deficiency and Interior Heat Syndrome

2.
Spleen Deficiency and Phlegm Dampness Syndrome

3.
Deficiency of Qi and Yin Syndrome

4.
Deficiency of Yin and Yang Syndrome

5.
Stagnation of Qi and Blood Stasis Syndrome

When evaluating someone for lung cancer, it is important to make sure that it can be differentiated from the following health problems.
Pneumonia
This is an acute and febrile disease which is caused by a wind-heat pathogen (substance causing a disease). According to TCM, it develops in four stages: the defense (wei) stage, vital energy (qi) stage, nutrient (yin) stage, and blood (xue) stage. At the beginning there will be a fever and cough which are the defenses against the pathogens. As chest pain, coughing, and yellow thick sputum develop, the pneumonia goes into the qi stage. When the pathogens interfere with the body receiving nutrients, the pneumonia enters the nutrient stage, and symptoms such as a high fever or convulsions may occur. Finally, when the pathogenic factors enter the blood, lethargy, coma and even death may occur if it is not treated properly.
Lung abscess
It is usually caused by a pathogen that originates form outside of the body and also has an acute onset. Symptoms like sudden chilling, high fever, chest pain, increased sputum production with a fishy smell or thick bloodstained sputum, and a cough are usually present.
Lung tuberculosis
It is caused by weakness, a deficiency of qi and blood, and the bacteria Mycobacterium tuberculosis. Its main active manifestations are a chronic cough, heamoptysis (coughing up blood or bloody sputum), fever, night sweating, fatigue and weight loss.

Western 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.

Chinese Medicine

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

Deduct:

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

 

 

Western Medicine

Preventing smoking is the single most effective way of stopping lung cancer. Keeping all indoor environments, such as offices, homes, schools, restaurants and forms of transport smoke-free is essential to preventing lung cancer caused by first and second-hand smoke. In many countries, legislation banning smoking in public areas is being used to protect people from the effects of smoking. However, in underdeveloped regions, many of which have young populations, indoor smoking is allowed and accepted as a social norm. In these countries, lung cancer rates are expected to rise dramatically as the children and adolescents now being exposed to smoking reach their forties and fifties.

Improving working environments where people are exposed to industrial smoke and other air pollutants will prevent lung cancer as well. Factories, mines and other enclosed work environments need to be well ventilated at all times. Workers exposed to pollutants should be given protective equipment, such as masks that are able to filter out pollutants. Workers in high-risk environments should only work in those areas for short periods and have their health carefully and frequently monitored by occupational health teams.

Children should never be exposed to tobacco smoke from parents, workers, teachers or any person coming into contact with them. Lung cancer results from cumulative exposure to tobacco smoke so the earlier the exposure; the more likely cancer will result in later life.

Homes, schools and offices need to be well ventilated to prevent radon gas accumulating. Opening windows is better than using air conditioning, except where temperature or pollution levels are extreme.

Chinese Medicine

Stop smoking.

Control atmospheric pollution by taking an active role in the environment.

Provide occupational protection by reducing the radiation dose to working personnel.

Take vigorous action to prevent and cure lung diseases like chronic bronchitis and pulmonary tuberculosis.

Detect lung cancer earlier by having regular physical examinations.

Western Medicine

Chinese Medicine