Chinese Medicine in Practice ACUPUNCTURE & ORIENTAL MEDICINE WINTER/SPRING 2014

INSIDE THIS ISSUE: AMEICAN ACADEMY OF Chinese Medicine in Practice ACUPUNCTURE & ORIENTAL MEDICINE WINTER/SPRING 2014

AAAOM Graduate 4 Brings TCM to Mayo Scientific Studies Support the Use of Clinic Acupuncture for Oncology Patients A Chinese Medicine 5 Perspective on Cancer: By Changzhen Gong, Ph.D. Seed and Soil In China, practitioners cluding pain, nausea of traditional Chinese How Chinese Medicine 7 and vomiting, xerosto- Understands the Pa- medicine (TCM) have mia (dry mouth), and thology and Treat- used acupuncture to ment of Cancer hot flashes, as well as address the symptoms quality-of-life issues Acupuncture Proves 10 of cancer for several such as fatigue, de- Effective for Chemo- thousand years, which pression, anxiety, and therapy-induced Nau- is documented in Chi- sea and Vomiting insomnia. There is al- nese medical texts. As so proof that acupunc- Using TCM Formulas 12 knowledge of acu- ture has powerful re- to Alleviate Symptoms puncture began to dif- of Chemotherapy and sults when used in the fuse beyond Asia in complementary treat- Radiology management of side ments in the field of the 20thstudies soon effects brought on by oncology. TCM Dietary Therapy 14 acknowledged the medical interventions for Cancer Patients ability of acupuncture A considerable body of surgery, chemother- to control pain and of evidence shows apy and radiotherapy. Prevent Cancer with 16 nausea. Today, the ap- Soy and Other Popular that acupuncture has Compared with many Chinese Foods plication of acupunc- a regulating effect on other interventions, ture therapy to cancer neurological, immune acupuncture is safe, U of MN Professors 21 patients is not con- -system, and endo- non-invasive, and has Present to Research fined to China, but is crine processes; and minimal side-effects. Finding to AAAOM being used and studied clinical observations Students, Staff and Alumni around the world. Pa- confirm that acu- tients who seek alter- puncture has many (Continued on page 2) natives to drug thera- beneficial effects dur- py for cancer-related ing cancer therapy. symptoms and treat- Scientific proof is ment-related side ef- mounting that acu- fects find that acupuncture is effective puncture has become treatment for cancer- one of the most popu- related symptoms in- lar, widely-accepted P A G E 2 Scientific Studies Support the Use of Acupuncture...

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Moreover, the use of acupuncture to treat pa- of giving patients a booklet with information tients with cancer and the symptoms that about managing fatigue). Acupuncturists needled arise from conventional cancer treatment is three pairs of acupoints once a week for six currently one of the most robust fields of sci- weeks. After six weeks, with 246 completing par- entific acupuncture research. The following ticipants, general fatigue levels were assessed us- paragraphs cite four recent cancer-related sci- ing the Multidimensional Fatigue Inventory entific studies which validate acupuncture (MFI). therapy and point the way for further investi- Other measurements included the Hospital gation into this field. Anxiety and Depression Scale, Functional Assess- An Italian study conducted by the Depart- ment of Cancer Therapy-General quality-of-life ment of Radiotherapy and Oncology at San scale, and expectation of acupuncture effect. Re- Gerardo Hospital, Monza, Milan evaluated the sults showed significant improvement in general efficacy of acupressure for insomnia fatigue levels in the acupuncture group. The in- (acupressure stimulates acupuncture points tervention also improved all other fatigue aspects manually, rather than with needles). measured by MFI, including physical fatigue and Of twenty-five study patients with sleep disor- mental fatigue, anxiety and depression, and qual- ders, fourteen of them had cancer. They were ity of life. This study concluded that acupuncture treated with acupressure for at least two con- is an effective intervention for managing the secutive weeks. A 60% overall improvement in symptom of CRF and improving patients' quality the quality of sleep was noted for the 25 pa- of life. tients, and an even higher improvement rate Xerostomia (dry mouth) after head/neck radia- of 79% was noted for the cancer patients. This tion is a common problem among cancer pa- study confirms previous clinical data showing tients. Quality of life (QOL) is impaired, and the efficacy of acupressure in the treatment of available treatments are of little benefit. A small sleep disorders, particularly in cancer-related pilot study comparing the effects of acupuncture insomnia. and sham acupuncture on xerostomia symptoms A study conducted by Molassiotis, et.al, and was conducted at the Fudan University Shanghai reported in the December, 2012 issue of the Cancer Center by Meng, et.al., and reported in Journal of Clinical Oncology, was designed to the July, 2012 issue of the European Journal of assess the effectiveness of acupuncture for Cancer. Twenty-three patients were randomized cancer-related fatigue (CRF) in patients with to real acupuncture (N=11) or to sham acupunc- breast cancer. The randomized controlled trial ture (N=12), with the objective of determining compared 227 patients who received acupunc- whether acupuncture could prevent xerostomia ture and usual care, with 75 patients who re- among head/neck patients undergoing radiother- ceived usual care alone (“usual care” consisted apy. (continued on page 3) P A G E 3 Scientific Studies Support the Use of Acupuncture ... (continued from page 2)

Patients were treated three times per week during the course of radiotherapy. They were QOL measures of pain severity and interfer- assessed by both subjective and objective ence, physical and psychological distress, life measures during radiotherapy, and were fol- satisfaction, and mood states showed im- lowed for one month after radiotherapy. In proved scores during treatment, with sus- this small study, true acupuncture given con- tained benefit at 12 weeks. currently with radiotherapy significantly re- This pilot study demonstrated that an 8-week duced xerostomia symptoms and improved outpatient acupuncture course was feasible for QOL when compared with sham acupuncture. advanced cancer patients and could produce a Researchers concluded that large-scale, multi- measurable benefit. Researchers also conclud- centre, randomized and placebo-controlled ed that acupuncture is underutilized as an ad- trials were justified, based on the results of junct cancer therapy. their pilot study. A study called “Acupuncture as palliative therapy for physical symptoms and quality of life for advanced cancer patients” was published in the June, 2010 issue of Integrative Cancer Therapies. Researchers assessed the effects of administering acupuncture to patients with advanced ovarian or breast cancer in regard to patients’ subjective experience of their symptoms and quality of life (QOL). In this single-armed prospective clinical trial, ambulatory patients with advanced cancer received 12 acupuncture sessions over 8 weeks, with follow-up treatments at weeks 9 and 12. Symptom severity was measured before and after each acupuncture session, and a compo- site QOL assessment tool was completed at five time points. The 32 assessed patients self- reported improvement in anxiety, fatigue, pain, and depression immediately after treatment, and significant improvement over time for patients with anxiety and depression. AAAOM Graduate brings TCM to P A G E 4 Mayo Clinic

By Kristin Weston, L.Ac., MSOM

American Academy of Acupuncture and Oriental According to the Dunn County News, acu- Medicine is proud to announce that one of our puncture at the Mayo Clinic Health Sys- graduates, Travis Young MSOM, L.Ac., has tem—Red Cedar is provided on a cash basis recently accepted a position with Mayo Clinic with no referral required. Health System—Red Cedar in Menomonie, WI. Young will be providing acupuncture services at Call Red Cedar Physical Rehabilitations at the Center for Prevention and Physical Rehabili- 715-233-7740 if you would like to make an tation there. appointment.

Young was quoted in the Dunn County Newspa- Young joins many successful graduates of per as saying “I am excited to be able to offer this the AAAOM Master Degree in Acupuncture service locally for people in our community who and Oriental Medicine program that are are suffering and searching for options.” The now working within a western care system news article went on to say that in addition to such as a clinic or hospital. acupuncture, “Young also provides some services under the scope of acupuncture that do not in- Congratulations volve needles. Gua sha, also known as dermal scraping, and cupping are used to help with cer- Travis Young, L.Ac.! tain pain conditions without using needles.” A Chinese Medicine Perspective on P A G E 5 Cancer: Seed and Soil

By Yuguang Jiang, Ph.D.(China),TCMD, L.Ac.

as the soil. A body which has an imbalance of Yin and Yang provides good soil for the growth of cancer seeds. Bodies with balanced Yin and Yang are bad soil for the growth of cancer seeds. What are some of the conditions or predisposi- tions which provide “good soil” for cancer seeds? The basic internal cause of Yin/Yang imbalance is deficiency of Qi, Blood, Yin and/or Yang. Long-standing deficiencies can lead to excess conditions of stagnation, phlegm and heat. External pathogens such as heat, cold, dampness and toxicity can attack the body and become lodged in tissues and organs. These complex combinations and interactions of Qi, Blood, Yin, Yang, internal and external, excess and deficiency can produce “good soil” for cancer seeds in any area of the body. However, dif- Traditional Chinese medicine (TCM), which has a ferent organs in the body are, by their nature, written history of more than two thousand years, prone to developing specific patterns of imbal- is firmly rooted in the natural world. Natural pro- ance. cesses of birth, growth, decay and death, seasonal For example, according to TCM theory, the cycles, and the interplay of the elements affect all Lungs dominate Qi. According to five-element human beings, and have strongly influenced TCM theory, the Lungs are classified as Yin-metal, theories of disease and wellness. prefer a moist (Yin) condition, and are dam- Ancient Chinese doctors could not analyze cancer aged by dryness. Therefore, patterns of lung cells under a microscope, but they would have cancer are almost always based in Qi and Yin been able to locate tumors, perform autopsies, deficiency, and the Lungs are easily attacked and see how various organs had been affected. and damaged by radiation therapy, which is They could also observe the disease process, its classified as Yang-fire. The zang-fu partner of progression, and the signs and symptoms pre- the Lungs, the Large Intestine, is classified as sented by cancer patients at each stage. From the Yang-metal. It is easily attacked by Yin-fire, holistic viewpoint of Chinese medicine, cancer which manifests as damp heat. So the pattern cells and tumors can be viewed as a seed, while for Large Intestine cancer is always damp-heat the body can be viewed syndrome. (continued on page 6 ) A Chinese Medicine Perspective ... P A G E 6

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As for treatment, modern Western medicine spe- In recent years, the development of integrative cializes in treatments which target the “cancer medicine has allowed modern medicine and seed,” like chemotherapy and targeted radio- traditional medicine to combine effectively in therapy. But traditional Chinese medicine spe- the treatment of cancer patients. For example, cializes in treating the “soil.” It is a well-known one of my patients was treated with radiothera- fact that our bodies often produce cancerous py for lung cancer, but then developed radia- cells, but most people will not go on to develop tion-related pneumonia. Hormone treatment cancer. The scientific explanation for this is that and antibiotic treatment were unsuccessful in our immunological system kills the mutated can- treating the pneumonia. Since the patient’s cer cells. TCM theory says that this soil is not TCM pattern was deficient Lung Yin and dry suitable for cancer seed growth. In clinical prac- heat attacking the Lungs, I adopted the treat- tice, Chinese medicine focuses on treating the ment principle of clearing heat and nourishing disease-causing syndrome, or pattern. If this Yin. After five days of drinking a Chinese herbal treatment is successful, TCM practitioners say decoction, the patient’s pneumonia was re- that the soil has been changed, and the patient solved. More and more often, modern medicine will be able to “carry cancer to his age,” meaning and Chinese medicine are working together to that the cancer seed is still there, but will not provide positive outcomes to cancer patients. progress or metastasize, allowing the patient to Many studies have shown Chinese medicine to live out his natural life. be effective in controlling some side effects of chemotherapy and radiotherapy such as pain, nausea, vomiting, and hair loss. How Chinese Medicine Understands the P A G E 7 Pathology and Treatment of Cancer Yubin Lu, Ph.D.(China), TCMD, L.Ac.

Traditional Chinese medicine (TCM) has been practiced for several thousand years, evolving unique theories and modalities of treatment for every disease and health condition experienced by human beings. It has its own understanding about the occurrence, development and treatment of cancer. The following is a brief intro- duction to the prevalent TCM view of cancer origins and treatment. Pathogenesis of Cancer in TCM: in general, the disease formation of cancer is complex, taking place over a period of time, with various contributing factors. TCM theory recog- Common external causes of normal path- nizes three most-likely pathogenic pathways to ogenic heat include infections, allergic reac- the development of cancer: toxic heat; Blood tions, or exogenous heat (like sunburn). In stasis/phlegm accumulation; and deficiency the pre-industrial age, external causes of patterns of Qi and Yin. toxic heat conditions included snakebite, virulent infectious diseases, or natural poi- Toxic heat is the most important pathologic sons. The modern world has added more factor contributing to the development of can- external sources of toxic heat, such as radia- cer. “Toxic heat” is differentiated from “normal tion exposure and an array of toxic chemi- pathogenic heat” by its strength and severity. cals. Toxic heat is much more powerful than regular pathogenic heat, and damages the body more Toxic heat in cancer patients can be severely, even causing death. Both kinds of heat the result of congenital constitution, can be generated by internal processes or by long-standing emotional stress, im- external “invasions.” The most common inter- proper diet, or exposure of the body nal pattern is for deficiency of Qi and Blood to external radiation or chemicals. to result in stagnation of Qi and Blood, damage All these factors can produce heat condi- to yin fluids, and accumulation of phlegm. tions in the human body. When they are strong enough, they may cause cancerous changes.

(continued on page 8) How Chinese Medicine Understands… P A G E 8 (continued from page 7)

Blood Stasis and Accumulation of Turbid The empirical evidence which supports the TCM Phlegm: The normal free flow of Qi and Blood theory that toxic heat is the strongest contribu- in the body may be impaired for any number of tor to the manifestation of cancer is as follows: reasons. When Qi and Blood are deficient, they First, most patients in the advanced stages of may slow down enough to stop and stagnate in cancer have a very dark red tongue, which indi- places. Stagnation or stasis of Qi and Blood cates both strong heat and some kinds of Blood causes pain, and can create heat. Strong toxic stagnation. Secondly, at the later stage of cancer, heat, whether from internal or external many patients exhibit manifestations of Qi and sources, may stagnate in certain areas of the Yin deficiency, such as weight loss, fatigue, etc. body, blocking the movement of Qi, Blood, and According to Yin/Yang theory, strong heat dam- body fluids. When body fluids are stagnant and ages yin fluids. The ancient Chinese medical subjected to heat, they solidify into phlegm, textbook, the Yellow Emperor’s Internal Classic, which is the origin of tumors and masses. says “strong fire eats Qi” (consumes the Qi of the body). Thirdly, the Chinese herbs which have Deficiency of Qi and Yin: For people with ei- been scientifically proven to be effective in con- ther a constitutional or an acquired tendency trolling the growth of cancer cells, such as Ban to Qi and Yin deficiency, this internal deficien- Zhi Lian, Bai Hua, and She She Cao, are all cy may lead to the development of stagnation, herbs which have the function of clearing toxic heat, accumulation of phlegm into tumor heat in Chinese medicine. masses, and ultimately to the manifestation of cancer. In the advanced and end stages of can- Another aspect of toxic heat as a contributor to cer, Qi and Yin deficiency are common in all cancer is its nature as a yang pathogen. Yang en- cancer patients, as the effects of toxic heat ac- ergy is very active. This may be a possible reason cumulate in the body. In most cases, by the fi- why cancer is prone to metastasize to other nal stage of the cancer process, the yin fluids of parts of the body. the body are depleted and exhausted. Qi deficiency is also common in the advanced and later stages of cancer, partly because toxic heat continues to damage body Qi, and partly because when Spleen Qi and Stomach Qi are deficient, the body is unable to digest food ade- quately to generate replacement Qi.

(continued on page 9) How Chinese Medicine Understands… P A G E 9 (continued from page 8)

TCM Treatment of Cancer Clearing toxic heat and the herbs for tonifying Over the centuries, TCM practitioners developed Qi and Yin, phlegm-dissolving herbs tend to be herbal formulas and acupuncture treatments to used as a supplement only, and are far less im- address the pathological conditions which were portant than the other two groups. considered to cause cancer, and to help patients deal with the symptoms of cancer. In modern Tonifying Qi and Yin: Groups of herbs with times, these TCM treatment modalities have the function of tonifying Qi and Yin are used in been very effective in supporting patients who the early, advanced and later stages of cancer. are undergoing standard cancer treatment such This is because cancer is a process in which tox- as radiation therapy and chemotherapy. Inter- ic heat continually damages the Qi and Yin of estingly, a number of the Chinese herbs which the body. Since there are no herbs in Chinese were traditionally used for clearing toxic heat medicine which are strong enough to stop toxic have been found to inhibit the growth of cancer heat and kill cancer completely, a better option cells, or even kill cancer cells. More research is to support the Qi and Yin of the body, so that needs to be done in this area. Following are the vital Qi can resist toxic heat effects and slow some TCM herbs and treatment principles down the progress of cancer. which have successfully addressed cancer- Chinese medicine can play a big role in this as- related symptoms. pect as a supplementary treatment to chemo- Clearing toxic heat: Since toxic heat is the therapy and radiotherapy. Herbs commonly most important pathogenic factor of cancer, used for this purpose include Huang Qi, Huang clearing toxic heat is a basic treatment for can- Jing, and Gou Qi Zi. cer. In the clinic, the most commonly-used Symptom-based treatment: As the cancer herbs for cancer include Ban Zhi Lian, Bai Hua, advances, many other pathologic changes will She She Cao, etc. These herbs were traditionally also happen. For example, nausea and vomiting used for conditions caused by toxic heat such as due to Stomach Qi deficiency, Yin deficiency, or carbuncles, snake bites, or swelling and pain due turbid phlegm obstructing the Stomach can be to toxic heat. treated with specific herbs such as Ban Xia, Dissolving phlegm, dissipating nodules Chen Pi, Zhu Ru, etc. Numbness of limbs and and removing blood stasis: Tumor masses other forms of neuropathy due to chemothera- are considered to be a result of Blood stasis and py are diagnosed in TCM as toxic heat blocking phlegm accumulation due to toxic heat stagna- the meridian collaterals. In this case, acupunc- tion. Therefore, herbs with the function of dis- ture or herbs that clear toxic heat and remove solving phlegm and removing Blood stasis are blockage from collaterals are a good option. often used when there are tumors. Such herbs include Ban Xia, Zhe Bei Mu, San Leng, and E Zhu. Compared with the herbs for Acupuncture Proves Effective for P A G E 10 Chemotherapy-Induced Nausea and Vomiting By Qin Chu, Ph.D.(China), TCMD, L.Ac.

For cancer patients, chemotherapy-induced nau- TCM treatment principles: sea and vomiting is a common side effect of stand- Tonify the Spleen, strengthen the Stomach, ard cancer treatment which can severely impair a promote descending Stomach qi, and stop patient's quality of life. Although anti-emetic nausea. medications have improved, many patients still suffer from these symptoms. In my twenty years Standard acupuncture point pre- as an acupuncture practitioner, I have found that scription: acupuncture treatment can significantly reduce RN 12; ST 36; PC 6; SP 4; HT 7. chemotherapy-induced nausea and vomiting. Needling method: In addition to the anti-emetic application described in this article, acupuncture can also im- RN 12 is punctured perpendicularly 0.5-1.0 prove patients’ appetites and immune system, and cun; ST 36 is punctured perpendicularly 1.0 enhance their disease resistance, while they are -1.5 cun; HT 7 is punctured perpendicularly preparing for or recovering from conventional an- 0.3-0.5cun; PC 6 and SP 4 are punctured ti-cancer therapies. perpendicularly 0.5-0.8 cun. All the points are punctured with even reinforcing- TCM pathogenesis of chemotherapy-induced nau- reducing manipulation by rotating the nee- sea and vomiting: Intravenous chemotherapy for dles. The needles are retained for 20 cancer is a development of modern medicine, so minutes. The treatment is done twice per there is no reference to it in ancient Chinese med- week. ical texts. However, a category of “drug toxicity” (continued on page 11) does exist in TCM, because there is a long history of administering strong medicines to address serious conditions. In TCM theory, the symptoms of nausea and vomiting indicate that it is the Spleen and Stomach which are primarily affected by the “external evil” of chemotherapy. Stomach qi normally descends, promoting digestion. But when the Stomach is attacked by toxicity, Stomach qi rebels and ascends, resulting in nausea and vomiting. Rebellious Stomach qi cannot support normal digestive function of the Spleen, resulting in deficient Spleen qi. experience mental stress with depression or anxiety. Acupuncture Proves Effective … P A G E 11 (continued from page 10)

Analysis of point prescription: RN 12, located over the stomach on the body’s

midline, is the Front-Mu point of the Stomach. The overall effect of this standard point pre- RN 12 functions to regulate the Spleen and Stom- scription is to tonify the Spleen and ach (middle Jiao), and promote the descending of Stomach, descend rebellious qi, stop rebellious qi. nausea, and calm the spirit. Additional ST 36, located near the knee, is the He-sea point points may be added, depending on each pa- of the Stomach meridian. ST 36 functions to toni- tient’s specific symptom presentation. Fol- lowing is an analysis of individual points and fy Spleen and Stomach qi. combinations: PC 6, located above the wrist, is the Luo- connecting point of the Pericardium meridian and is one of the Confluent points connecting with the YinWei meridian. PC 6 functions to nourish the Heart and calm the spirit, as well as regulating qi activity in the chest and middle Jiao. SP 4, located on the foot, is the Luo-Connecting point of the Spleen Meridian and one of the Con- fluent points connecting with the Chong meridian. SP 4 functions to strengthen the Spleen and harmonize the middle Jiao. The combination of PC 6 and SP 4 is highly effective to treat disorders of the Stomach, Heart and chest, and promotes the normal downward descending of Stomach qi to stop nausea and vomiting. HT 7, also located on the wrist, is the Yuan- Source point of the Heart meridian. HT 7 functions to nourish the Heart and calm the mind. The combination of PC 6 with HT 7 is especially useful to calm the spirit and reduce mental stress, since it is generally the case that cancer patients experience mental stress with depression or anxiety. Using TCM Herbal Formulas to Alleviate Symptoms P A G E 12 of Radiotherapy and Chemotherapy

By Wei Cheng, Ph.D.(China), TCMD, L.Ac.

According to traditional Chinese theory and practice, the development of tumors is due to deficiency of body energy (qi) and dysfunction of the organs and viscera (zang/fu). We de- scribe this process in TCM as: a pathogenic toxin enters the body and lingers in meridians, collaterals and viscera because of a weakened state of health. There exists an imbalance of yin and yang in the body which leads to qi stagnation, blood stasis, congealed phlegm, and toxin Chemotherapy is a way to use poison as a med- accumulation. The end result of this process is icine to disrupt the cells that are forming the the formation of a tumor. tumor. However, the heat-fire pathogen and Qi deficiency is the major internal factor for toxin can further impair the movement of qi in this process, and the invading toxin is the main the already-weakened body by damaging stom- external factor. The growth of the tumor will ach and spleen energy, further consuming the further consume the qi of the body, making the vital qi of the body. qi deficiency even more serious. The formation The impairment brought about by heat-fire can and development of a tumor is the result of the manifest as qi and yin deficiency, qi and blood struggle between vital energies and pathogenic deficiency (by interruption of the transporta- factors in the entire body, with the tumor itself tion and transformation function of stomach being the local manifestation. and spleen), and liver-kidney deficiency. A tu- Usually, the pathogenesis of a tumor is defined mor patient will often experience more serious as “deficiency in root and excess in branch.” vital qi deficiency after the heat-fire pathogen That means the local manifestation (the tumor) or medicine treatment, as evidenced by low- is excessive but the body itself is deficient, es- ered immune function. pecially at the later stages of tumor develop- The TCM treatment strategy for a patient who ment. has experienced radiotherapy and/or chemo- Radiotherapy and chemotherapy are standard therapy usually includes herbal formulas from treatments for a tumor. The side effects of two main categories: these treatments, however, can affect a pa- 1.) Those that invigorate the spleen and tient’s quality of life to the extent that he may tonify qi, and consider abandoning treatment. In these cases, I have seen Chinese medicine make a difference 2.) Those that tonify qi and nourish yin. in patient quality of life, and help a patient continue with his treatment. TCM doctors think of (continued on page 13) radiation therapy as a heat-fire pathogen, and of chemotherapy as a heat-fire toxin. Using TCM Herbal Formulas to Alleviate Symptoms… P A G E 13 (continued from page 12)

1.) Invigorate spleen and tonify qi: 2.) Tonify qi and nourish yin:

In this pattern, a patient often presents with In this pattern, a patient often presents common spleen and qi deficiency symptoms with common qi and yin deficiency symp- such as vomiting, nausea, diarrhea, abdominal toms such as: dry mouth and throat; five- distention, vertigo, lassitude, palpitation, and centers heat (feeling hot in the palms of pale face. The herbal formulas Si Jun Zi Tang the hand, soles of the feet, and upper and Bu Zhong Yi Qi Tang are often used to treat chest); insomnia; tidal fever (feeling hot in this pattern. Single herbs frequently used for the afternoon); night sweats; lassitude; red this pattern include Ren Shen, Huang Qi, Dang tongue; and thin and rapid pulse. Herbal Gui, Shan Yao, Fu Zi, Yi Yi Ren, Shan Dou Gen, formulas Sheng Mai Yin, Bu Gan Tang, or Tu Fu Ling, Ban Zi Lian, etc. Liu Wei Di Huang Wang can be applied to this pattern. Frequently-used single herbs are Sha Shen, Tian Dong, Mai Dong, Gui Ban, Ban Zhi Lian, Xia Ku Cao, Bai Hua, and She She Cao.

Chinese Herbal Formulas being prepared in TCM pharmacy TCM Dietary Therapy for Cancer Patients P A G E 14

By Yifan Liu, TCMD, Ph. D.(China), L.Ac.

The aim of treatment is to balance Yin and Yang and to harmonize the patient’s internal environment. As a holistic medicine, TCM focuses on strengthening the individual’s resistance to disease as much as mitigating un- pleasant symptoms. TCM modalities have proven effective in treating the side effects of conventional cancer treatment, such as nausea and vomiting, loss of ap- In Chinese medicine theory, disease results from petite, and insomnia. They can control pain, both external and internal imbalances. To vary- and help to keep the immune system strong. ing degrees, a health problem will be influenced There are specific herbal substances which are by an individual’s innate constitution, by the cu- used to address particular conditions, regard- mulative effects of lifestyle choices, and by an less of the overall energetic evaluation. For ex- “attack” from the environment. Cancer is a com- ample, the herb Huang Qi (Astragalus) in suffi- plex condition, generally resulting from a num- cient dosages may help prevent fatigue and ber of influences. The basic internal state that raise white blood cell counts, allowing chemo- pre-disposes one to cancer is deficiency of the therapy to continue. fundamental substances: Qi, Blood, Yin and Herbs such as Sha Ren (cardamom seeds) and Yang. Deficiency leads to stagnation of these Sheng Jiang (fresh ginger) are useful in pre- substances, which in turn leads to development venting nausea. Herbs such as Ji Xue Teng of excess pathogenic factors including Blood sta- (Caulis Ji Xue Teng) have demonstrated a po- sis, phlegm, and toxic substances. Once a person tent effect for raising white blood cell counts. develops cancer, standard interventions such as chemotherapy or radiotherapy can become pathogenic agents in themselves, causing Blood sta- (continued on page 15) sis and toxic heat, and further damaging the person’s Qi, Yin, and body fluids. The holistic nature of Chinese medicine includes the use of Chinese herbal medicine and dietary therapy. Treatment of cancer symptoms and treatment side effects is based on the principle of Fu Zheng Gu Ben. “Fu Zheng” means assisting Zheng Qi (healthy Qi);“Gu Ben” means strengthening and consolidating Yuan Qi (source Qi). TCM Dietary Therapy ... P A G E 15

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The following recipes are often recommended to Fu Ling and Yi Yi Ren Porridge cancer patients in China as a healthful way to Ingredients: cope with symptoms of cancer and side effects of treatment: Fu Ling (Poria) = 20g American Ginseng and Lian Zi (lotus Bai Zhu (Largehead Atractylodes Rhizome) = seed) Soup 15g Ingredients: (Note: 30g = 1 oz) Coix seed (Job’s Tears) = 30g American ginseng root (Radix Panacis) = 20g Millet = 15g Lotus seed (Semen Nelumbinis) = 60g Rice = 100g

Preparation：Rinse the ingredients; soak in Sugar = 30g water for 4 hours. Add a sweetener of choice to Preparation: a.) Make a decoction of the Fu the liquid (Chinese cooks traditionally use rock Ling and Bai Zhu: add herbs to 1200 ml of sugar). Bring to a boil, reduce heat, and sim- water (approximately 5 cups), and bring to a mer for one hour, or until ingredients are soft. low boil for 20 minutes. b.) Strain the liquid and discard the herb residue. c.) Add the coix TCM Function: Tonify Qi and Yin; invigorate seed, rice and millet to liquid decoction and the Spleen and Kidneys; and calm the spirit. simmer over low heat for 30 minutes until it Symptoms Treated: Dizziness and sweating turns into a thick soup. d.) Remove from heat, due to Yin deficiency pattern; shortness of add sugar and serve. breath; feeble voice; fatigue. TCM Function: Invigorate the Spleen and expel dampness. Symptoms Treated: Fatigue; weakness; poor appetite; skin rashes; loose stools. Prevent Cancer with Soy and P A G E 16 Other Popular Chinese Foods

By Wei Liu, TCMD, L.Ac., Lic. Nutritionist

One out of three people alive today in the Unit- foods, and are wonderful substitutes for ed States will ultimately die of cancer. More and meat, chicken, eggs, and cow’s milk. more often, people in this country, including Although Asian people have long claimed health professionals, are questioning the con- that soy foods promote increased health ventional treatments for cancer. Are surgery, and longevity, it is only recently that West- chemotherapy, and radiation therapy the only ern researchers began performing scientifi- options for cancer patients? Interestingly, since cally controlled, double-blind studies on surgery, chemotherapy, and radiation therapy soy beans and their chemical constituents. became the standard treatments for all cancer When Asian scientists pointed out that cas- patients, data indicates no improvement in ei- es of breast cancer and prostate cancer are ther the incidence of cancer or the survival rate. significantly lower in Asian countries than Many people are now turning to Eastern medi- in Western countries, and attributed this cine to try to find an answer. My patients often fact to diet; and when it was further pointed ask me if Chinese medicine offers cures or pre- out that American women who consume ventive methods for cancer. soy foods have a fifty-percent lower inci- Many types of cancers appear to be diet-related. dence of cancer than women who don’t eat It has been estimated that 60% of cancers in soy, many Western scientists decided it was women are diet-related. Evidence shows that time to investigate these phenomena. some foods increase the likelihood of develop- So far, it has been discovered that soy beans ing cancer, while others reduce the likelihood of contain at least five known anti-cancer developing cancer. agents, including protease inhibitors, phy- In Chinese medicine, diet is considered to be a toestrogens, saponins, and genistein. Peo- major factor in cancer prevention. Many foods ple have been aware for decades that soy have been tested scientifically and found to con- beans contain protease inhibitors, but it tain anti-cancer agents. Some of the most excit- was thought that protease inhibitors inter- ing research has been done on soy beans and fered with proper digestion, so they were soy food products. Soy beans are considered to actually removed from all soy products pro- be one of the five sacred foods in China. For a duced in the United States. Only now are typical Chinese family, every meal includes soy protease inhibitors recognized as valuable foods: soy milk for breakfast; tofu salad at cancer fighters that inhibit tumor growth lunch; a tofu and vegetable stir-fry for dinner. by inhibiting the action of certain enzymes Even formal banquets feature many soy-based that promote tumor growth. dishes, often marinated with garlic, sesame, soy sauce, or ginger. Soy products are easily made (continued on page 17) into noodles, breads, and snack Prevent Cancer with Soy … P A G E 17 (continued from page 16)

Most people, including most health profession- Until recently, soy beans have been under- als, had never heard about genistein until 1993, appreciated in this country, and are often when Dr. Herman Adlercreutz’s research on associated with animal fodder or extreme prostate cancer was cited in the Wall Street poverty. When I first came to America, I Journal. Genistein, a type of phytoestrogen, would extol soy foods to my patients, only blocks the signal that triggers normal cells to to be met with skepticism. “Soy beans? – become cancer cells, and is extremely effective that’s cow food!” said one. A journalist told in stopping the growth and spread of prostate me he had eaten a lot of soy foods when he cancer. Scientists have speculated that genistein was a poor student. It is a big challenge for may even be used as a cancer treatment. Alt- Americans to switch from meat and pota- hough more than three hundred plants contain toes to tofu and soy milk, but health- phytoestrogens, only soy beans produce conscious people are beginning to change. genistein. Now that a variety of soy products are avail- Phytoestrogens, which are heavily concentrated able in many city markets, it is well to rec- in soy, seem to create a favorable hormonal en- ognize that some of them contain more vironment which prevents certain cancers from phytoestrogens than others. In order to en- developing, especially breast cancer. The phy- joy the maximum benefit from soy foods, I toestrogens in soy have a similar chemical struc- recommend that you purchase organically- ture to the estrogen produced by the human grown soy beans whenever possible, and body, but phytoestrogens are considered to be learn to make your own soymilk at home. “weaker” than the body’s natural estrogen. “Strong” estrogens which bind to the body’s estrogen receptors are recognized as being a trig- (continued on page 18) gering mechanism in the development of breast cancer. Unfortunately, the women in “advanced” countries have not only their natu- rally-produced estrogen to deal with, but also the strong estrogens that come from the environment – from water, from meat, or leached into our foods and beverages from plastic con- tainers. When soy is consumed, the natural weaker estrogen in the soy binds with the body’s estrogen receptors, thus leaving fewer estrogen receptors available for the risky, stronger estrogen which is then discharged harmlessly from the body. The faster strong estrogens are metab- olized and discharged, the less damage they can cause. Chinese tofu or bean curd Prevent Cancer with Soy … P A G E 18 (continued from page 17) People often confuse green tea with black tea, Oolong tea, Jasmine tea, and many other Asian teas. All tea is made from leaves picked from the same plant – the difference is in the processing. Green tea leaves are simply picked and sun-dried; other teas are either fermented or cooked. It is the lack of processing that makes green tea contain the most potent anti-cancer agents. A leading physician, Dr. Hirota Fu- jiki, at Japan’s National Cancer Center Re- Making Soymilk at Home: search Institute, claims that drinking green Step 1. Soak 1 cup of dried soybeans in three tea could be one of the most practical meth- cups of cold water for 8 hours. ods of cancer prevention available to the general public at present. Step 2. Combine each ½ cup of soaked soybeans with 3 cups water and grind in a blender Cabbage, the most popular vegetable in at high speed for one minute into a fine slurry. the northern part of China, can be found in many traditional dishes, including stir-fry Step 3.Use a piece of nylon mesh to strain the vegetables and dumplings. The Chinese val- soymilk into a pot or a large bowl. ue it, not only for its good taste, but also for Step 4. Cook the soymilk on a medium flame, its wonderful anti-cancer effect. Studies boiling it for 5-10 minutes. show that cabbage can speed up the metab- Step 5. Flavor the soymilk (if you like), and olism of estrogen in the body. It is thought store it in the refrigerator. that slower metabolism of estrogen promotes breast cancer. Another very interest- ing study done on cabbage concerned guin- Besides soy products, other cancer-preventing ea pigs who received high doses of radia- foods which are popular in China include green tion. The study showed that all of the guin- tea, cabbage, shiitake mushrooms, garlic, kelp, ea pigs who were exposed to high levels of carrots, and cauliflower. Green Tea, the most radiation and did not have cabbage in their popular drink in China, Japan and other Asian diet died; but the group of guinea pigs who countries, contains powerful anti-cancer sub- ate cabbage had a very high survival rate. stances called catechins. Many studies show This study indicates that cancer patients that green tea can dramatically block the devel- who are receiving radiation therapy would opment of various cancers. Epigallocatechin gal- be wise to include substantial portions of late (one of the most potent catechins) is found cabbage in their diet. in the highest concentrations in green tea. (continued on page 19) Prevent Cancer with Soy ... P A G E 19

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and reduce hard masses. It is also popu- Shiitake Mushroom. This brown and beefy larly used for weight control in China. It is -tasting mushroom has been used in Asian so popular in Asian cuisine that it is con- gourmet cooking for centuries as a substitute sidered a necessity in the Chinese and for meat. Its taste and texture are very differ- Japanese diet. Kelp soap, kelp shampoo, ent from that of regular mushrooms. It has and kelp hair conditioners are extensively used in modern China. gained fame as an immune system booster, widely recommended to cancer and AIDS pa- Carrots. Most people already know that tients. The biochemical in the shiitake mush- carrots contain high levels of beta caro- room that has been proven to augment im- tene, and that beta carotene has an anti- mune system activity is called lenitan. Today it cancer effect. Carrots are widely con- is possible to find shiitake mushrooms in sumed around the world, but in many many supermarkets and Asian groceries in the countries, especially in the West, people dried form. Fresh ones are also available in eat them raw. Experiments show that eat- some co-ops. Shiitakes are delicious and can ing lightly-cooked carrots is much more be prepared in a variety of ways: cooked or beneficial than eating raw carrots, which steamed with rice or noodles; or added to stir- confirms the ancient wisdom in tradition- fry and soups. al Chinese medicine. Traditional Chinese medicine practitioners have always rec- Garlic. As a food and a spice, garlic is used ommended that their patients eat lightly- widely in both the East and the West. Scien- cooked carrots in order to get the best nu- tific studies show that garlic can “deactivate” tritional absorption. Recent research by carcinogens, prevent the growth of cancerous Dr. Xiangdong Wang at Tufts University tumors, and stimulate the formation of gluta- shows that beta carotene can change in thione which detoxifies foreign materials. Gar- the human body into a substance called lic contains allicin which has antibiotic and retinoic acid, which is widely used to treat anti-fungal properties. People call it a natural cancers. chemotherapy drug because of the way it de- stroys cancerous cells. It is especially preven- (continued on page 20) tive of colon and stomach cancers. One of garlic’s components, ajoene, is very toxic to malignant cells. The maximum benefit is achieved by eating raw garlic. Kelp is a seaweed which tops the list of thera- peutic Chinese foods for its anti-cancer properties. It is rich in many minerals and other special nutrients such as iodine. Traditional Chinese medicine believes that kelp can soften Prevent Cancer with Soy ... P A G E 20

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An Anti-cancer Recipe: Chinese Stir- Cauliflower. In ancient times, Chinese med- fry Vegetables icine texts set out the theory that foods which Ingredients: look like tumors have an anti-tumor effect. In the West, the theory that “like treats like” is 1 teaspoon olive oil; 1 tablespoon soy sauce; 1 called the “Doctrine of Signatures.” Cauliflow- tablespoon of vinegar; 1 teaspoon grated er, which looks exactly like a cancer tumor, fresh ginger root; 1 teaspoon sliced garlic. 2 has long been a folk remedy against cancer. cups sliced cabbage; 2 cups sliced shittake Recently, its effects on cancer have been prov- mushroom; 1 cup sliced carrot; 1 cup fresh en scientifically: it contains many cancer- soy bean sprouts. fighting, hormone-regulating compounds, and Preparation: is especially good for the prevention of breast and colon cancers. Heat olive oil in a wok. Add ginger root and garlic and stir-fry for one minute. Add cab-

bage, carrot, shiitake mushroom and soy bean sprouts and stir-fry for 4 minutes. Add vinegar and soy sauce and stir-fry for a few seconds. Serve with rice.

University of Minnesota Professors Present P A G E 21 Cancer Research Findings to AAAOM Students, Alumni, and Faculty

Last year, AAAOM was honored to host in- triptolide, works to halt the development of formative lectures by two respected professors HSP 70 in tumor cells. However, it was dif- and researchers from the University of Minne- ficult to administer triptolide as a drug, be- sota. Dr. Ashok Saluja and Dr. Alvin J. Beitz cause it is not water-soluble. Dr. Saluja and conduct scientific research into disease mecha- his team patented a method to create an nisms at their laboratories, and graciously injectable chemotherapy drug from trip- shared some of their recent significant findings tolide, which proved to be highly effective with lecture attendees. against pancreatic cancer in animal models. Lunchtime lectures at AAAOM feature They named their discovery Minnelide, in short talks in the speaker’s field of inter- acknowledgement of the University of Min- est, and are open to AAAOM stu- nesota and the compound triptolide. dents and alumni, and members of the public, free of charge. In his lecture, Dr. Saluja described The first lecture, entitled “Pancreatic the process and development of Cancer Meets Thunder God Vine,” Minnelide, as well as the complexi- was presented by Dr. Ashok Saluja on ties physicians face in treating pan- Thursday, March 28, 2013. Dr. Saluja is Profes- creatic cancer. sor and Vice Chair of Research at the University “Can Acupuncture Control Cancer of Minnesota Medical School’s Department of Cell Growth?” was the title of Dr. Alvin J. Surgery. A Chinese herb, Lei Gong Teng Beitz’s lecture, presented on December 2, (Tripterygium Wilfordii), is at the center of Dr. 2013. Dr. Beitz is the Chair of the Universi- Saluja’s groundbreaking research in the treat- ty of Minnesota’s Veterinary and Biomedi- ment of pancreatic cancer. (The translation of cal Science Department, and a professor of Lei Gong Teng is “thunder god vine.”) anatomy and neuroscience. Dr. Beitz dis- Cancer cells protect themselves with a “survival cussed his newly published research paper, protein” called HSP 70. In 2007, Dr. Saluja and “The Effect of Electroacupuncture on Oste- his collaborators found that pancreatic cancer osarcoma Tumor Growth and Metastasis: cells produce a lot of HSP 70, making pancreatic Analysis of Different Treatment Regimens,” cancer especially aggressive and difficult to and presented some basic neuroscience treat, since regular chemotherapy drugs do not models of acupuncture and acupuncture counteract HSP 70. Researchers found that a analgesia. compound derived from Lei Gong Teng, called (continued on page 22) University of Minnesota Professors Present Cancer Research P A G E 22 Findings to AAAOM Students, Alumni, and Faculty

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Osteosarcoma is the most common malignant Lunchtime lectures at AAAOM bone tumor found in children and adolescents, feature short talks in the speak- and is associated with many cancer-related er’s field of interest, and are complications including pain and metastasis. open to AAAOM students and Cancer patients have found that complementary alumni, and members of the and alternative medicine approaches can suc- public, free of charge. Find us cessfully address cancer pain, fatigue, and the at: side effects of chemotherapy. However, little is known about the effect of acupuncture treatment on cancer itself, in terms of tumor growth and metastasis. www.aaaom.edu Recently, Dr. Beitz’s laboratory conducted a study which evaluated the effects of six different electroacupuncture (EA) regimens on osteosarcoma tumor growth and metastasis in both male and female mice. The most significant positive effects were observed when EA was applied to the ST-36 acupoint twice weekly (EA-2X/3) beginning at postimplantation day 3 (PID 3), which produced robust reductions in tumor growth. Conversely, when EA was applied twice weekly (EA-2X/7), starting at PID 7, there was a significant increase in tumor growth. EA-2X/3 treatment also produced a marked reduction in pul- monary metastasis, thus providing evidence for EA’s potential anti-metastatic capabilities. Dr. Beitz’s research interest also includes mecha- nisms underlying acupuncture’s anti- inflammatory and antinociceptive effects. We are proud to offer a rich heritage of Traditional Chinese Medicinal Practice and Education to our patients and students. We have been recognized by our

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