Ayurvedic Treatment of Cancer

The following article series was written by Dr. Marc Halpern. Part one focuses on the basics of cancer from a Western perspective while part two and three will focus on Ayurvedic knowledge of Cancer and its herbal, nutritional and holistic management. 

By far, cancer is the most feared of all disease. Taunting humanity with the threat of a slow, painful death it is often the first disease people think they have when they experience pain or feel a lump in their bodies and the last they want to talk about. Going to the doctor, patients wait with baited breath for the phone call that tells them, yes or no. That one phone call either brings tremendous relief, exhilaration and an appreciation for life or it brings shock and despair. While cancer is a devastating disease, the likelihood of dying of cancer is much less than dying from cardiovascular disease (heart attacks and strokes). Cardiovascular disease remains the number one killer and is responsible for three times as many deaths as all cancers combined. Still, approximately one in five people will develop some form of malignant cancer at some time in their life. 

Managing Cancer Part I

This is the first of a three part series exploring cancer. Part one focuses on the basics of cancer from a Western perspective while part two and three will focus on Ayurvedic knowledge of Cancer and its herbal, nutritional and holistic management.

Introduction

By far, cancer is the most feared of all disease. Taunting humanity with the threat of a slow, painful death it is often the first disease people think they have when they experience pain or feel a lump in their bodies and the last they want to talk about. Going to the doctor, patients wait with baited breath for the phone call that tells them, yes or no. That one phone call either brings tremendous relief, exhilaration and an appreciation for life or it brings shock and despair. While cancer is a devastating disease, the likelihood of dying of cancer is much less than dying from cardiovascular disease (heart attacks and strokes). Cardiovascular disease remains the number one killer and is responsible for three times as many deaths as all cancers combined. Still, approximately one in five people will develop some form of malignant cancer at some time in their life.

What is Cancer?

Cancer is a proliferation of cells in the body which undergo unregulated growth. These cells often spread by seeding themselves though out the body. Typically growing in the form of tumors, new tumors emerge as cells take root and grow in different parts of the body. Death occurs when the body's life support functions are compromised due to the cellular damage.

When cancer is talked about, what is meant is a malignant tumor. A malignant tumor is one with the tendency to grow and invade surrounding tissues. Benign tumors, while still cancerous pose a much lesser threat. They are encapsulated and are much less likely to spread. Often, they can be removed surgically and no additional treatment is required. Metastatic tumors are malignancies which have already spread. Metastatic cancers are generally the most dangerous.

Determining the Prognosis

The prognosis for a cancer patient decreases significantly with metastasis. This is the main reason the medical profession encourages routine tests for early detection. A patient's prognosis also decreases with the extent of metastasis. The more sites, the less likely recovery is. Another factor in the prognosis is the exact location of the tumor. A tumor located in a vital organ or near a vital function of the body is more difficult to treat. Finally, the type of cell involved in the cancer can indicate how aggressive the cancer will tend to be.

The Many Causes of Cancer

While most people will never have cancer, every body produces cancerous cells. Every day, even in healthy people, malignant cells are formed and circulate. In a normal, healthy body, these cells are destroyed by the body's immune system. In patients who develop cancer, something has compromised the body's ability to effectively deal with these cells.

Developing cancer is dependent upon many factors. Most certainly, one of these is genetic. The body has certain genes called "Oncogenes." Oncogenes are mutated genes which regulate cell growth. Proteins in these genes signal the cell to divide when it is not suppose to. Exposure to environmental carcinogens and viruses are responsible for converting regular genes to "Oncogenes."

Our bodies are designed to deal with this threat. Additional genes called "Tumor repressor genes" normally suppress or regulate growth. Mutations however can cause these genes to fail and again, unrestricted growth occurs. Chromosomal abnormalities have been linked to a large number of cancers including leukemia and lymphoma.

Viruses appear to play an important role in the onset of cancer. A virus is a strand of genetic material that is able to insert itself into the DNA of its host, replicate and thereby alter the functions of the host. While often the body's defenses can rid itself of the aggressive intruder, other times the intruder imbeds itself deep inside the DNA and the body appears defenseless against it. Altering the bodies DNA, these mutations can be passed down from generation to generation. Viruses are the closest physical evidence that there is to support something akin to the idea of possession. Common viruses known to cause cancer include HPV (Human Pappilloma Virus) , CMV (Cytomegalo Virus), EBV (Epstein Barr Virus) and Hepatitis B. In addition, any pathogen that causes chronic inflammation increases the risk of cancer.

Environmental contamination is often blamed for causing cancer. Indeed, environmental contaminants have been proven to increase cancer risk. Chemical carcinogens cause cells to mutate through a series of stages. These stages of mutations are often dependent upon contact with ordinary chemicals which by themselves are not a threat but when combined with a carcinogen triggers mutation. These chemicals are called "co- carcinogens. The list of common chemicals known to cause cancer is very long and include many pesticides, diesel exhaust, lead based paint fumes, formaldehyde and a variety of hair dyes.

The cause of cancer is complex. There are many factors that contribute. In additional to genetic tendencies, viruses and environmental contaminates, ultraviolet light, radiation from x-rays, nuclear power plants and nuclear weapons testing and the use of immunosuppressive drugs all are important factors. In addition, people with a history of autoimmune diseases, whose immune systems are clearly not functioning properly, are also at higher risk.

The Red Flag Signs and Symptoms

Early signs and symptoms of cancer are not often present. Cancer often develops in the body for quite some time before the body's functions are compromised and symptoms are noticeable. This is one more reason why early detection through non invasive testing is so important. Patients who experience unexplained weight loss, night sweats, unexplained pain (especially at night) and abnormal bleeding from any orifice should seek a complete examination as soon as possible.

The Major Cancers

Lung cancer is the most common form of cancer and is the leading cause of all cancer deaths. Bronchogenic carcinoma responsible for 90% of all lung cancers is very aggressive, Eighty seven percent of these cancers are attributed to cigarette smoking.

Colorectal Cancer is the second most common cancer. It tends to affect adults over the age of 40. Scientists accept that a diet low in fiber and high in animal protein contributes to this condition. A vegetarian diet that includes whole grains should significantly reduce the risk. A simple blood test is available for screening called CEA (Carcinoembryonic Antigen).

Breast Cancer affects 13% of woman by age 95. This is the most common form of cancer in woman. While many middle aged woman develop breast cancer, risk increases dramatically after age 75. Eighty percent are first discovered by the patient as a lump. By the time they are discovered, many have metastasized into surrounding lymph. Early detection through daily breast examinations and mammograms offers the possibility of finding the cancer prior to metastasis and greatly improves prognosis. Studies show that annual mammograms reduce the mortality rate of breast cancer by 25 - 30%. While there are risks of radiation exposure from mammograms, most medical professionals believe that the potential benefits outweigh the risks. Breast cancer is responsible for 3.5% of all deaths in woman. A woman who is free of cancer in her lymph nodes following therapy has a 10 year survival rate of 80%

Woman with a family history of breast cancer and those who have taken birth control pills are at higher risk. Other factors that increase risk include becoming pregnant after age 30 and early start of menses, late occurrence of menopause, radiation exposure and hormone replacement therapy.

Prostate Cancer is the most common malignancy in men over age 50. Some studies have shown that a majority of men will develop prostate cancer if they live long enough. While generally a slow growing, mildly aggressive cancer it does have the ability to metastasize and kill. Blood tests (Prostatic Specific Antigen test) can reveal the presence of prostate cancer. While a positive test indicates cancer a negative test can not rule it out. The value of all blood screening tests for cancer is controversial.

Endometrial Cancer is the 4 th most common malignancy in woman. Risk increases dramatically after age 40 and peaks between ages 50 - 60. The greatest correlated risk factor is obesity. Other important risk factors include: estrogen replacement therapy, the choice to have or the inability to have children (nulliparity) , ovulatory disorders and late menopause. The condition has also been correlated with high estrogen levels in the body in comparison to progesterone. Most cases present with abnormal vaginal bleeding as the first sign.

Cervical Uterine Cancer is the result of sexually transmitted pathogens and is less common than endometrial cancer. Risk increases with the number of sexual partners a woman has had and with the early loss of one's virginity. Human Papilloma Virus (HPV) clearly plays a role. HPV is the cause of genital warts. Cigarette smoking also increases the risk.

Ovarian Cancer affects one in 70 women. And one of every one hundred woman dies of it. Its incidence increases around menopause and in post menopausal woman. Surprisingly, the risk of developing ovarian cancer decreases with oral contraceptive use. Known risk factors include obesity, nulliparity, infertility, late childbearing and late menopause. A blood test is available for screening. The test is called CA-125. The accuracy of all blood screening tests is controversial.

Malignant Melanoma is the most aggressive form of skin cancer. While the condition is very aggressive and very often fatal when diagnosed in its late stages, early diagnosis leads to a nearly 100% cure rate. Other skin cancers such as Basal cell and Squamous cell carcinomas are less aggressive with lower rates of metastasis. Medical treatment of these cancers is quite effective.

American Cancer Societies Recommended Screening Procedures

Procedure

Frequency

Self Breast Exam (Screen for breast cancer)

Monthly after age 18

Breast Exam by a professional (Screen for breast cancer)

Every 3 years age 18 -40. Every year after age 40

Pap Smear Test (screens for endometrial cancer )

 

Yearly age 18 - 65 and then at the doctors discretion

Pelvic Examination (Screen for multiple cancers of the female reproductive system)

Every 1-3 years, age 18 - 40, then yearly

Chest X-ray (Screen for lung cancer)

Only if there is high risk

Sputum Cytology (Screen for lung cancer)

Only if there is high risk

Rectal Exam (Screen for prostate cancer)

Yearly after age 40

Blood PSA (Screen for prostate cancer)

Yearly after age 50

Stool exam for occult blood (Screen for colorectal cancer)

Yearly after age 50

Sigmoidoscopy (Screen for colorectal cancer)

Every 3-5 years beginning age 50

 

Traditional Cancer Therapy

Traditional cancer therapies are based on two simple principles. Remove the cancerous cells when possible and destroy any cells that remain. To accomplish these goals, surgery is utilized when a malignant cancer is found that has not metastasized. Surgery may also be performed if there is metastasis if the removal of a tumor will increase the quality of life or if all surrounding lymph nodes are easily accessible.

Either in addition to or as an alternative to surgery, radiation therapies are employed. These therapies utilize gamma, neutron, proton, and electron radiation to destroy localized tumors. For some cancers such as Prostatic cancer and certain brain cancers, a radioactive seed may be implanted into the tumor to destroy the tumor from the inside out. Radiation may also be employed as an isotope injected into the blood if the cancer has a tendency to pick up the isotopes from the blood stream. This is common to thyroid cancers. While radiation damages or kills malignant cells it also causes damage to near by healthy cells.

Chemotherapy is the use of drugs to destroy cancer cells. Drugs are non specific and are spread throughout the entire body. These drugs are highly toxic and destroy both healthy and cancerous cells. As crude as it sounds, the success is dependant upon the ability of the drug to kill the cancerous cells before it kills the patient. Common side effects of chemotherapy include vomiting, mouth sores, hair loss and loss of appetite.

For some cancers, endocrine therapies are somewhat effective. Endocrine therapies involve altering levels of hormones in the body. In the management of prostate cancer, an orchietomy (removal of the testes) may be performed to decrease testosterone levels. In addition, estrogen may be administered. By decreasing testosterone and increasing estrogen the growth of prostatic cancer cells is slowed. Other cancers such as breast cancer respond positively to lower estrogen levels. A drug called Tamoxofin is sometimes used as a part of the treatment for breast cancer. It works by lowering estrogen levels. In addition, the ovaries are often removed to further reduce estrogen levels.

Biological Therapies are employed in the treatment of certain blood and lymph cancers. Interferon and Interleukins are anti-viral drugs. These slow down the progression of leukemia and lymphomas and in some cases leads to cure.

The Western approach to managing Cancer brings both opportunities for cure as well as great challenges. With early detection, prior to metastasis, Western Medicine can often offer patients excellent results. However, the long term prognosis for cancers which have metastasized is much less optimistic. In part two of this series, the Ayurvedic knowledge and approach to cancer will be explored as well as important nutritional and herbal therapies.

Managing Cancer Part II

Part one of this series detailed the Western understanding of cancer, its pathophysiology, statistics, screening tests and treatment. In part two of this three part series the Ayurvedic concepts of gulma, granthi and arbuda shall be introduced.

Ayurvedic Terminology and the Field of Cancer

Cancer has been understood to exist for thousands of years. While cancer may be more prevalent today in part because people live to a greater age than in the past, Cancers have always occurred. Healers since the beginning of time have tried to understand the condition and manage those who have been suffering.

Classical Ayurvedic texts have several references to cancer. Some terms used to describe the condition are general while others are much more specific. Practitioners should familiarize themselves with common terminology so that they can benefit from historical knowledge as well understand information that is published in India . The following terminology describes the most basic concepts.

Gulma is a term used to describe any palpable hard mass in the abdomen. This does not mean that gulma is cancer but rather any hard, tumor like mass in the abdominal region.

Granthi is a term for a tumor, lump or nodule that is visible from the surface. These tumors often open up on the surface of the skin as an ulcer (vrana). Granthi may be benign or malignant; however the term is most often used to describe benign tumors.

Arbuda is the most specific term for a cancerous malignancy.

Dwirabuda indicates that the malignancy has metastasized or spread from its initial site to other parts of the body.

Samprapti

From an Ayurvedic perspective, tumor formation is a condition of vata- kapha origin. Vata is responsible for the faulty division of cells and kapha for their growth. Hence, vata pushes kapha out of balance resulting in tumor formation. Benign tumors take on a predominantly kapha appearance.

In malignancies, pitta is also vitiated and the condition becomes sannipattika in nature. In these conditions, the agni of the affected tissue is increased making it very aggressive to its surroundings as it slowly digests the tissues of the body.

While at first, the interplay of the doshas may not be clear, over time vata imbalance predominates and the condition leads to severe wasting of the tissues of the body. Ojas in the affected tissue is always low as Cancer begins. As the condition progresses, systemic ojas becomes lower and lower.

Muscular tissue is the most common dhatu affected by cancer though any dhatu can be. Benign tumors of muscular origin are most often described as kapha entering into the mamsa dhatu and the mamsavaha srota. This is true even though it may be vata that has pushed kapha. Malignant tumors of muscular origin are most often described as pitta vitiation in the mamsa dhatu and mamsavaha vaha srota. This is true even thought there is simultaneous vitiation of vata and kapha. As the condition progresses, additional sites (dhatus and srotas) of the pathology become important.

Gulma

Types: There are eight basic types of gulma. One related to each dosha, one from each combination, a tridoshic type and one type due to disorders of the artava.

Nidana: A long list of non specific causes are provided by the classical texts for the origin of gulma that include the suppression of natural urges, grief, becoming weakened by fever, vomiting or diarrhea and then eating food that vitiates vata. Other causes include drinking cold water when hungry and beginning purification without proper oleation and fomentation. These causes are quite generalized toward poor health practices and emphasize those that vitiate vata.

Purvarupa: Generalized purvarupa include all kinds of digestive disturbances such as belching, borborygmi, gas and constipation.

Comparative Rupa: (Dual dosha and tridoshic gulma combines the symptoms of the involved dosha)

Vataja gulma presents with tumors in the large intestine or pelvic region. There may be pain in the in the neck and head with fever. Patients feel cold and the spleen is often enlarged. There are usually signs of digestive discomfort such as constipation and borborygmi (intestinal churning). The mouth and skin are usually dry. Patients usually lose weight as the condition progresses. The skin, nails, eyes and feces typically become dark or gray. Texts describe the tumor as feeling as if one was being swarmed by ants. Pain is throbbing or cutting. The tumor may appear to move about and change in size and shape. Naturally, symptoms are worse on an empty stomach and during the vata times of day.

Pittaja gulma presents with tumors in the small intestine or solar plexus. Patients feel greater pitta type digestive discomforts such as hyperacidity and diarrhea. Patients run fever and the skin, nails, eyes and feces may become yellow. Pain at the site of the tumor may be described as burning. Pain is naturally worse during the pitta times of day and shortly after eating as food is digesting.
Kaphaja gulma presents with tumors in the chest or stomach. Patients present with typical symptoms of kapha vitiation such as loss of appetite and nausea. In addition, taste is significantly reduced and patients feel cold with a low fever. The skin, nails, eyes and urine take on a whitish hue. The tumor appears deep, hard, and heavy and is non mobile. Not surprisingly, the tumor does not produce much pain and grows slowly in size. Symptoms are worse during kapha times and immediately after eating.
Raktaja Gulmais a tumor arising from the blood in the artavavaha srota and occurs only in woman. This is the term used to describe of ovarian cysts and uterine fibroids. The condition is described as being like a false pregnancy where a mass forms instead of an embryo. KRL Gupta in his commentary on the Madhava Nidanam tells of an embarrassed physician who told a woman and her family she would die of the Gulma. He stated that it would increase in size, it would produce great pain and that nothing could be done for her. The woman was isolated from friends and family and left to die where upon she delivered a healthy female child. Because of the difficulty of diagnosing Rakta gulma and pregnancy, ancient texts recommend waiting until the 10 th month to treat the condition. The distinguishing feature is whether or not there is movement of the fetus. Naturally, in our modern age a distinction can be made quite early. This condition often presents with excessive menstrual bleeding leading to fatigue with anemia.

Samprapti: The primary cause of gulma is stated to be vitiation of vata but this can mix with doshas in other locations. Vitiated doshas failing to be eliminated remain in their home site or may mix with the other doshas in the digestive tract. The path of elimination of the doshas is obstructed in both an upward and downward manner preventing elimination. Excess dosha then becomes palpable as a lump

Prognosis : Single dosha involvement is the easiest to treat, dual dosha is more difficult and sannipattika type is stated to be incurable through Ayurveda. According to the Madhava Nidanam, the prognosis is terminal if the tumor fills the abdomen, has the shape of a tortoise shell, there is loss of appetite, debility, nausea, cough, vomit, discharge of mucous from the mouth and nose and loss of taste or smell. Systemic swelling is also a poor sign.

Gulma Chikitsa
Regardless of the type of gulma, patients benefit from a diet that is warm, light and oily. This diet reflects the predominance of vata in the pathology. Over the region of the tumor, oleation and fomentation are recommended to pacify vata. Blood letting at the site of the tumor is also classically recommended. Agni should be properly managed. In most cases, agni will be low and hence a dipana is suggested to be taken in takra if possible. A simple formula recommended by Chakradatta is Yavani Takra prepared by mixing Yavani (Henbane: Hyoscymus Niger ; nervine sedative, antispasmodic and pain reducer) with a pinch of salt into takra.

Vata Gulma benefits from anuvasana basti if the tumor is below the umbilicus. A vata type tumor above the umbilicus requires oral oleation. Chakradatta suggests mixing 1 part ginger with 4 parts sesame oil and 2 parts jaggery taken in hot milk. Other medicines recommended by Chakradatta include castor oil or garlic taken in warm milk. Purifying bastis may also be performed in accordance with the principles governing such therapy.

Pitta Gulma benefits from the intake of bitter medicated ghee as the preferred method of oleation. This should be followed by fomentation and then purgation. Milk basti prepared with bitter herbs help to reduce the size of the tumors. Blood letting should also be considered.

Kapha Gulma benefits from fasting and the practice of vamana. While internal oleation is not necessary, a paste of sesame, castor, linseed or mustard oil should be applied to the site of the tumor and this should be followed by fomentation. Herbs taken should have a strong pungent and / or bitter quality. Virechana should be performed using castor oil. Niruha basti should be performed using dashmool.

Dual and tridoshic gulma benefits from the combined treatment of the doshas involved. Special herbs mentioned in classical texts to be used to help break up the tumor include calamus, long pepper, chitrak and hing. As these herbs are all warming they are best for gulma that is vata ? kapha in nature.

Rakta Gulma is best treated with oleation and fomentation followed by purgation. In order to break up the tumors, herbs with an alkali quality (strong caustic bases) are recommended. Common herbs that are important in the management of rakta gulma include ashoka and manjistha. It is important to note that it is expected to be seen that the proper treatment of rakta gulma will lead to a temporary increase in bleeding. Care should be used to make sure that the patients does not become too weak from the treatment.

Granthi (Benign Tumors)

Types: Granthi is categorized to be of 9 kinds by Vagbhat. There is one caused by each dosha, and six categorized by the tissue that is vitiated. These tissues are: rakta, mamsa, medas, asthi, sira (vein) and vrana (ulcer). Other authors have added additional types such as nadi dhatuja, lasika granthi, lasika vahini and tilaja

Samprapti: Kapha plays the predominant role as it enters the affected dhatus. The most common dhatus affected are medas, mamsa and rakta. The result is slow growing cancer of a benign nature.

Rupa:
Vataja granthi presents with a visible tumor that is black or dark in color and is non fixed. It is able to move from place to place if pushed. Its size may fluctuate. It tends to be soft and if pricked, exudes a clear, thin fluid.

Pittaja granthi present with burning over the tumor. The tumor or the region surrounding it will be yellow or red in color. The tumor suppurates quickly and easily and exudes a warm blood when pricked.

Kaphaja granthi presents as a painless, hard tumor whose color is pale. The area around the tumor is cool and itches. The tumor suppurates slowly and if pricked, exudes thick, white, cloudy pus.

Raktaja granthi presents with symptoms similar to pitta and a loss of tactile sensation. This is believed to be causes by an infestation of parasitic worms.

Mamsaja granthi presents essentially as a myoma or benign tumor of the muscle. Closely related are myxomas which are tumors of the connective tissues called snayuaja granthi in Ayurveda. These are large, hard tumors which are moist or oily and tend to be very vascular. They ulcerate and bleed easily and often become malignant. These tumors are associated with meat consumption.

Medaja granthi presents similar to a lipoma or fatty tumor. These often occur on the back, neck, shoulders and wrists. They are caused by either the intake of too much fat or faulty fat metabolism. With kapha at the root of these tumors, they present as being soft. Vata contributes to the condition causing the tumors to also have a movable nature. When they ulcerate, they exude a coppery, black or white fatty fluid. There may be itching with this type of tumor as well but no pain.

Asthi granthi presents similar to an osteoma and also as bone spurs. They often occur secondary to fractures and boney stress. These tumors appear as hard growths within the bone.

Sira granthi are vascular tumors such as angiomas. While they may be benign, many become malignant. They are stated to follow the sudden exposure to cold water on the feet. Sira granthi are painless and they do not pulsate.

Vrana granthi refers to tumors which form of the dried blood surrounding a wound or ulcer. Vrana means ulcer.

Nadi dhatuja granthi refers to benign tumors of nerve origin such as neuromas and neurofibromas (schwann cell tumors). These present as masses within nerve tissue.

Lasika granthi refers to lymphadenomas. This is a general term for any tumor of the lymph glands. These may become malignant.

Lasika vahani refers to lymphangiomas. These are masses of anomalous lymph vessels that are present at birth.

Tilaja granthi refers to skin cancer. Though categorized as a type of granthi it should be listed as a type of arbuda as these are malignant cancers.

Sadhyasyata (Prognosis)

Ayurvedic prognosis depends on factors such as the relationship of the condition to the patient?s constitution, age and the season the condition occurs within. Those arising from the three doshas, rakta and medas are curable and consider easier to treat. Those that are large, hard and located on marmas along with those occurring in or on the throat and abdomen are said to be incurable.

Granthi Chikitsa

According to Vagbhatta benign tumors that have not suppurated are treated in a manner similar to swelling. In addition, purification therapies should be applied following proper oleation. When purification is complete, a penetrating paste can be applied to the tumor.

One simple suggested paste is that of turmeric, manjishta and mung dal. The area is then fomentated and squeezed gently as the tumor ripens. This procedure is repeated over and over. The goal is to draw the tumor out. This treatment is true for tumors of all three doshas but most especially those of vata nature. Due to the application of heat and paste, the tumor should ripen and allow itself to be squeezed. If this does not occur the tumor should be removed by surgical means. It was well known that if the entire tumor was not removed it would surely grow back again. In the case of pitta granthi, it is recommended to apply leeches to the tumor and heat is avoided or minimized. The open wound should be washed with cool infusions of herbs and allowed to heal.

Arbuda (Malignant Cancers)

Types: There are six kinds of malignancies. They are vataja, pittaja, kaphaja, raktaja, mamsaja and medaja. Sarcomas are considered a type of mamsaja arbuda.

Arbuda Chikitsa

The classical management of Arbuda (malignancy) is considered to be similar to the management of granthi (benign tumors) in so much as the treatment noted under granthi is applied first. In addition, poultices are prepared with specific herbs, spices and oils and applied to the tumor. Herbs are chosen which pacify the affected dosha. This is then followed by localized steam therapy such as nadi swedana. Specific formulations for each poultice are provide in Chakradatta and other classical texts.

According to Sushruta, vataja arbuda chikitsa responds to a simple poultice prepared with boiled fatty meat and spices. Pitta arbuda chikitsa requires milder fomentation and purgation in addition to the other therapies while kapha arbuda chikitsa requires both vamana and virechana be performed.

Medaja Arbuda (Fatty malignancy) is first fomentated and then the surgically opened. According to Sushruta, the wound is then thoroughly cleansed, sutured and plastered with healing herbs.

Conclusion

Ancient knowledge provides important clues for the modern practitioner who desires to provide his / her patient with the best possible care. In this modern age cancer remains a primary threat to society and Western medicine offers little in the way of conventional treatment for many types of cancer. Thus, we must look for answers in the timeless sciences steeped in the knowledge, lore and wisdom of Nature herself. There lie treasures to be re-discovered that may one day bring an end to suffering.

References:

Clinical Methods in Ayurveda: Prof K.R. Srikanta Murthy: Chaukambha Orientalia, Second Edition, Copyright 1996

Ashtanga Hrdayam: First ed, translation by: Prof. K.R Srikantha Murthy: Krishnadas Academy , Varanasi , Copyright 1995

Madhava Nidanam: K.R.L. Gupta, Second edition, Sri Satguru Publications, Copyright 1997, Delhi , India .

Sarngadhara Samhita: Prof K.R. Srikantha Murthy, Chaukhambha Orientalia, Second edition, Copyright 1995. Delhi , India .

Cakradatta: Translated and edited by PV. Sharma, Chaukhumbha Orientalia. First Edition, Copyright 1994.

Caraka Samhita: Translated by R,K. Sharma, Commentary by Bhagwan Dash, Chaukhambha Sanskrit Series. First Edition, Copyright 1998. Varanasi , India .

Sushruta Samhita: K.L. Bhishagratna, Chaukhambha Press, Fourth Ed, Copyright 1991, Varanasi , India

Ayurvedic treatment of cancer - Ayurveda herbs and therapies for cancer

This is the third in a three part series on cancer. In part one, Dr. Halpern detailed the Western understanding of cancer, its pathophysiology, statistics, screening tests and treatment. In part two, he introduced the Ayurvedic concepts of gulma, granthi and arbuda and their classical treatments. In this issue, Dr. Halpern provides a complete overview of the many potential holistic treatments that may be offered by the practitioner of Ayurveda.

Introduction

Patients who present with cancer have three basic options for treatment. The first and the most conventional treatments utilize chemotherapy, surgery and radiation. Second are a wide range of alternative therapies, and third is a combined approach. There are benefits and challenges regardless of which decision is made. Conventional treatments for cancer have varying success rates. For some cancers, when caught early, conventional therapies do have a high success rate. Success decreases as the cancer progresses. For some cancers, such as pancreatic cancer, there is little conventional medicine can do to effect a cure even if it is caught early. Conventional medicine, backed by extensive scientific studies, offers the patient the opportunity to know what they are getting into before treatment begins. Statistics are available for the success and failure of treatment. A list of side effects for each treatment is also available. This information is important to patients who will be making choices that literally affect their own life or death. Alternative medicine offers many possible therapies, ranging from dietary changes, the use of herbs, and nutritional supplements to psychic, crystal and energy healing, visualization therapies, prayer and meditation, light and color therapies and much more. While there is anecdotal evidence of success with many of these methods, alternative methods lack the studies and statistics that show success and failure. As a result, those who choose alternative methods of healing from cancer are doing so primarily on faith or an inner belief system that supports this path. Some patients and practitioners choose to integrate conventional and alternative therapies. The attitude of some oncologists (cancer specialists) is that if it won't hurt you, go ahead and try it. This attitude becomes more pervasive as the condition spreads and conventional treatments fail. At this time, both practitioner and patient start looking for miracles. One concern of the oncologist is that some alternative medicines might interfere with the effectiveness of their conventional medical treatment. As a result, many oncologists tell their patients not to utilize herbs while also undergoing chemotherapy. This concern is justified, because herbs do contain active pharmacological substances that may support or interfere with treatment. While some research is now being done on drug and herb interaction s , extensive and conclusive knowledge is not available.

The Role of the Practitioner

The first decision facing a patient is what path to choose. Conventional? Alternative? Integrative? There is no one right answer. In my practice, patients are encouraged to make their own decision, as it is their life that is on the line. The practitioner must act as a resource to help educate their patient about the possibilities. The more the practitioner knows about the type of cancer and the available treatments, the more they can educate their patients. No practitioner, medical or alternative can make promises of a cure. Healing is the work of God and Nature. The practitioner can only hope to be a conduit of practical knowledge, universal energy and divine love. There is more to healing than the medicine (conventional or alternative) the patient takes. It is not just the practitioner's vital knowledge that is important, but their heart. A practitioner is who is compassionate, kind and present is one who is prepared to be a conduit for the divine. Knowledge is useful and important, but it is not the stuff of miracles. Miracles often arise out of the patient and practitioner relationship, because when the patient has faith, confidence and belief in the practitioner, hope is kindled and healing is possible. Studies have shown that the role of the mind and the disposition of the patient are important to the final outcome of any treatment. Practitioners who understand this keep the door open to miracles.

The Role of the Patient

Healing from cancer requires not only a skillful, knowledgeable and compassionate practitioner but a responsible, insightful and compliant patient who understands their role in the healing process. The process begins by gathering information about their condition, the choices available for treatment, and the known information about the success and complications of each approach. For the patient ready to take responsibility for their choices and insightfully engage fully in the process of healing, many questions arise. What does this disease have to teach me? What role did I play through my actions, thoughts and emotions in creating the condition? What can I change in order to better align myself with the energies of nature? Patients willing to engage in heart opening practices open themselves up to receiving divine grace and its power of healing, stimulating self-compassion and self-love. Patients must also be willing to undergo lifestyle changes, the hardest and most powerful part of the healing process. Changes in lifestyle can remove and break the offending pattern of actions that bring about imbalance. That in turn creates a new form of suffering. This is called tapas - the process of giving up attachments that ultimately provides the patient with new power. Personal power or the boons (graces) of the divine, this power is among the most potent forces of healing. Also, the best patient is compliant, doing all that the practitioner asks and allowing the practitioner to guide them through the healing process. When the hearts of the patient and practitioner are open, divine love and light have two paths through which they can enter, bringing about the miracle of healing.

The Ayurvedic Approach to Healing

The physical level Ayurveda approaches the patient on several levels of causes, including physical, emotional and spiritual. The most superficial level is approaching the symptom, which is the tumor itself. On the most superficial physical level are herbs that can reduce tumor growth and perhaps limit metastasis. Herbs can be taken internally or applied over the tumor as a paste, acting directly on the cancer and supporting a deeper healing when used in accordance with the patient's vikruti. The practitioner must also decide if the patient requires tonification or purification therapy. Strong patients with ama require purification therapies in accordance with their prakruti and their vikruti. Purification therapies reduce ama along with excess dosha. By cleansing the srotas and the subtle nadis of the body, prana can flow freely and support the healing process. Purification is a reducing therapy, reducing the dhatus of the body as well as the doshas. Since this weakens the body, it should only be performed in patients who are strong enough. Purification therapy can be similarly viewed as cytotoxic, meaning it destroys cells. When applied properly, cellular destruction is directed primarily toward the cancerous cells. Patients who are weak should undergo strengthening or tonification therapy. These therapies attempt to build up the strength (ojas) of patient. Consisting primarily of oil therapies and rejuvenative herbs, these therapies are not directly beneficial for destroying cancer cells, but do invigorate the immune system. A strong immune system is required for controlling the growth of cancer cells. Ideally, patients begin Ayurvedic treatment early when they are strong, allowing the practitioner to take the patient through a period of purification followed by a period of tonification or rejuvenation. This process leaves the patient's body purified and their immune system strong. In addition to the management of ama and ojas, the most important system of the body to manage is the digestive system. Considered the root of physical disease, a healthy digestive system supports the healing of all tissues of the body. The digestive system is managed though the removal of ama, proper diet and herbs as well as vamana, virechana and basti applied appropriately with due regard for prakruti and vikruti. The Mental Level The role of the mind in healing must be emphasized as mental disturbances are a more subtle cause than the physical imbalances in the doshas. Healing the mind is therefore more difficult and requires positive self-inquiry and insight. Studies have indicated that positive thinking activates the immune system and supports healing. Yet, positive thinking is not easy to sustain. A consciousness that is more tamasic or rajasic will have a difficult time sustaining a positive focus. Mental and emotional challenges produce blockages in the flow of energy in the physical body. The physical body is capable of manifesting what the mind imagines. Unhealthy imaginings (images produced deep within our consciousness), appear first in the astral body (dream body) and can eventually manifest in the physical body as disease. Healing begins with the purification of the mind. Periods of silence and a lack of sensory stimulation are the best methods of purifying the mind, and can then be supported through the use of herbs such as brahmi, tulsi and calamus. In addition to the internal use of these herbs, shirodhara can help produce inner silence while tonifying the mind. Nasya supports mental purification. For patients with a more tamasic nature, this path of healing is very difficult. They will often lack the motivation for self-inquiry and will not fully engage in the subtle therapeutic process. These patients benefit from traditional Western psychotherapy, which begins the process of self-awareness through exploring and releasing repressed feelings. By removing obstruction to the flow of prana in the body, psychotherapy can be an important part of the patient's healing process. So much of one's mental power of healing lies in their capacity to experience self love. A lack of self-love, contentment and compassion equates to a lack of mental ojas and are the additional roots of all diseases including cancer. Hence, mental purification is the process of removing these negative feelings. Mental rejuvenation must follow mental purification. This is accomplished through the use of oil therapies such as shirodhara and abhyanga. While all types of oil massage are beneficial, daily self-abhyanga is the most important act of self –love because it rebuilds ojas in the mind. Caring for the body nurtures the ego, while devotional practice s nourish our higher spiritual Self. The Spiritual Level Our spirit is essentially pure, perfect and is not truly in need of healing. However, our spirit is bound to the cycle of birth and death through the Karma generated by the actions of our ego. Spiritual healing is the process of removing or healing our karma, which plays a role in all disease. Cancer has a cause. While some of those causes are exogenous, others are endogenous, arising from within. They originate in the samskaras deeply imbedded within our consciousness and manifest in part through our genetics and i n part through the desires (vasanas) that generate our actions. Our genetic predispositions combine with the choices we make to bring about our challenges. In this case, the challenge is cancer. Spiritual healing is the healing of the samskaras and the underlying karma that generated it. In doing so, cancer magically seems to disappear. Hence, healing is learning. When the lesson is learned, the condition is no longer necessary. Lessons often surround destructive lifestyle habits, thoughts, and emotions, and exist to give us the opportunity grow, learn and evolve on our journey toward enlightenment. Without suffering, we would have no feedback about how we are living or progressing on our spiritual journey. Healing the spirit by removing our karma and freeing ourselves from suffering and the wheel of rebirth is the greatest journey of all. It is often the most difficult and lengthy path of healing, but also the most complete path. While this part of the healing journey will go on for the patient's entire life, and even their next, each change in the patient's consciousness alters how they manifest in this lifetime. Even small changes at the level of consciousness can be enough to heal cancer!

The Power of Visualization

Visualization is the process of engaging the imagination in the process of healing. Because of the strong mind/body connection, what is imagined affects our physiology. This includes our immune system. By visualizing a positive outcome, chances of survival and healing are increased. To be successful, patients should engage in the process several times per day, sitting quietly for 15 to 30 minutes. Healing visualizations can be quite varied, and often include: seeing the body's immune system destroying the cancerous tumors; visualizing the body as strong, healthy, active and serviceful, and visualizing divine light and love entering the body through the crown or heart chakras bringing about healing by loving the cancerous cells to death.

Sattvic Healing Practices

Sattvic practices are important for keeping the mind clear and supporting the healing process. A clear mind reflects the light of God. Sattvic practices assist in the healing of karma. Patients benefit from spending more time in nature, taking walks in the forest or by the ocean. Meditation is the king of all sattvic practices. By finding the inner silence the patient dives deep into the well of unlimited potential. Yoga asana is the queen of sattvic practices, and is among the most transformative practices a person can engage in. Gentle motions reducing tension and inner restrictions combined with diaphragmatic breathing makes yoga asana a perfect metaphor for flowing with nature, allowing her energies to course through us, removing blockages and promoting healing. All patients with cancer will benefit by reducing stress and engaging in activities that bring joy, and should be encouraged to pursue their love of art, music, writing, and other forms of self expression, and be surrounded by loving friends and family.

Dietary Therapies

Ayurvedic knowledge about diet is quite extensive and patients should follow a diet appropriate to their prakruti and vikruti. Conventional wisdom teaches us that certain foods should be emphasized and others avoided. Cancer patients should avoid all processed, genetically engineered foods, refined sugars, and foods that contain additives. These foods are tamasic in nature and, according to Ayurveda, clog the channels and upset normal bodily functions. Patients should also avoid over-eating. Following the accepted Ayurvedic guidelines for healthy eating include saying grace before eating, avoiding too much water with meals, chewing food properly, combining foods appropriately and resting for a while after eating. Proper food choices are essential to normalize digestion and prevent the formation of ama. Water taken throughout the day should be as pure as possible. The exact diet a patient with cancer should follow depends upon their prakruti, vikruti, state of ama, agni and ojas. The practitioner must make decisions based upon sound reasoning allowing some room for intuitive creativity. For prevention of cancer, it is widely held, even in scientific circles, that a diet which includes large amounts of fruits and vegetables is most likely to prevent cancer. Fruits and vegetables have been found to contain a wide range of phytochemicals that are being shown in animal studies to reduce the incidence of many cancers. Some of these phytochemicals and the foods they are found in include: Sulforaphane (cauliflower), P. Coumaric Acid (tomatoes), Genistein (soy beans), Capsaicin (chili peppers) and Flavanoids (citrus fruits).

Healing Cancer with Herbs

While everyone is looking for the definitive cure for cancer in an herb, Ayurvedic practitioners know that healing is more than taking a pill. Herbs offer great potential to stimulate the healing process and can even destroy cancer cells. This property of an herb (or drug) is called the cytotoxic effect. While studies reveal that herbs have cytotoxic or antineoplastic (preventing cancerous cell growth) activity, few have documented their exact effect. Historical references often state simply that herbs are beneficial in a general sense, but do not specify which types of cancer they are effective for, or at what stage. In the classical Ayurvedic literature, there are listings of complex formulations for the treatment of various types of arbuda (malignancy). Many of the herbs that are credited with the potential to heal cancer are strongly purifying, ridding the body of toxins, excess dosha and ama. Most of these purifying and reducing herbs are bitter in taste. While there are hundreds of herbs with presumed anticancer effects, several examples of strongly reducing herbs with a reputation to destroy tumors include red clover, burdock root, dandelion root, guggul, turmeric and chaparral. Other specific herbs have been well studied, and include: Green tea (Camellia sinensis), has been shown to reduce the incidence of a variety of cancers, including the most impossible to cure, pancreatic cancer, and also to prevent stomach, colon, and breast and lung cancer. This conclusion was based upon a study of the population of China which showed that as tea consumption increased, cancer rates sharply decreased. A study in Japan showed green tea to reduce the likelihood of metastasis in patients with breast cancer and overall improved prognosis. Still, the main action of green tea appears to be preventative and its effects in patients with cancer are largely unknown. Cat's claw (Uncaria tomentosa) has been shown to actually reduce cancerous cellular growth. These studies were performed on leukemic cell lines in 1998. Manjishta (Rubia cordifolia) has been shown to have mild antineoplastic activity and is often used as a part of uterine and ovarian cancer formulas. Madagascan Periwinkle (Vinca Roseus) is an example of an herb from which anti-cancer drugs have been produced. The young leaves contain two phytochemicals used to produce the drugs vinblastine and vincristine. These drugs help to treat leukemia and lymphoma. It has also been used in the treatment of breast cancer. Shatavari (Asparagus racemonus) and Brahmi (Bacopa Monniera ) has also have been found to possess anticarcinogenic activity. An alcoholic extract of both herbs has been shown to be effective in reducing epidermal carcinoma of the nasopharynx. Shatavari is a rare example of a nutritive herb with anticarcinogenic properties.

 

Ayurvedic Energetics of all Anti Cancer Herbs Mentioned in this Article

Common Name

Botanical Name

Rasa

Virya

Vipaka

Doshic Effects

Cat's Claw

Uncaria tomentosa

Bitter

Cool

Pungent

PK- V+

Green Tea

Camellia sinensis

Astringent

Cool

Pungent

PK- V+

Manjishta

Rubia cordifolia

Bitter

Cool

Pungent

PK- V+

Madagascan Periwinkle

Vinca roseus Catharathus roseus

Unknown

Unknown

Unknown

Unknown

Shatavari

Asparagus racemonus

Sweet

Cool

Sweet

VP-K+

Guggul

Commiphora mukul

Bitter, pungent, astringent, sweet

Warm

Pungent

VK- P+

Red Clover

Trifolium pratense

Bitter, sweet, sweet

Cool

Pungent

PK- V+

Burdock

Arctium lappa

Bitter, sweet

Cool

Pungent

PK- V+

Turmeric

Curcuma longa

Bitter, astringent, pungent

Warm

Pungent

VK- P+

Chaparral

Larrea Divaricata

Bitter

Cool

Pungent

PK- V+

The proper management of a patient with cancer requires all of the skills of the practitioner. Armed with knowledge, compassion and an open heart, the practitioner is prepared to engage the patient and the disease. When working with a patient who is willing to engage in self – inquiry and insight and is able to make lifestyle changes the stage is set for miracles to occur. Through the grace of God and the love of Mother Earth, healing is possible.