The patient, Ms. Fu, 61 years old, was admitted to the hospital on August 19, 2009 as an outpatient with “lung cancer” due to “right lung occupancy for 3 months, after chemotherapy”. In April 2009, the patient developed a cough without any obvious cause, with a small amount of white sputum, without symptoms such as fever, chest pain, chest tightness and wheezing. On May 12, 2009, he developed coughing blood, and chest X-ray showed a right hilar mass and right pleural fluid. On May 18, 2009, the chest CT showed a soft tissue mass in the middle lobe of the right lung, enlarged mediastinal lymph nodes and right pleural effusion; bronchoscopic biopsy showed adenocarcinoma of the right lung, clinical stage IIIb, TNM stage T2N1MX. three cycles of chemotherapy with GP (Kinzel + cisplatin) were administered. In August 2009, the patient did not complete the fourth cycle of chemotherapy and discontinued chemotherapy due to chemotherapy resulting in grade III myelosuppression (white blood cells below 2000).
At the time of admission, the patient was on the 9th day after the last chemotherapy treatment. His symptoms were: tiredness, laziness, little breath, little food, occasional cough, no sputum, no fever, chest pain, sleep was fine, and bowel movements were regulated. Physical examination: superficial lymph nodes were not enlarged, right lower lung breath sounds were diminished, dry and wet rales were not heard. The tongue is light and fat with tooth marks, the coating is white and greasy and peeling, and the pulse is thin. On admission, routine blood tests were performed: white blood cell count 2800/mm3, hemoglobin 89g/l, platelets normal, and normal liver and kidney function. As chemotherapy brought great pain to the patient’s body, the patient said on the day of admission, “I will never go back to chemotherapy, it’s too uncomfortable!” The rehabilitation doctor understood the patient’s feelings and comforted her: “Don’t be afraid, chemotherapy is only temporary, we are here to help you recover!” Dong Qian, Department of Oncology, Guang’anmen Hospital, Chinese Academy of Traditional Chinese Medicine
According to the patient’s pulse, TCM diagnosed lung accumulation and identified lung spleen qi deficiency type. The Chinese medicine was formulated with the method of strengthening the spleen and benefiting the qi, and one dose was given daily. Chinese patent medicines and herbal injections were given to support and fight against cancer. Chinese herbal infusion, fumigation and magnetic therapy were given to tonify the kidney, strengthen the spleen and open the ligaments. Acupuncture was applied to foot San Li, Feng Long, San Yin Jiao and Yin Ling Quan, moxibustion to foot San Li and Guan Yuan to strengthen the spleen and stomach, and to cultivate Qi and blood; ear acupuncture pressure beans were selected from liver, gallbladder, spleen and Shen Men ear acupuncture points to strengthen the spleen and resolve dampness. Psychological counseling and music therapy were given along with TCM treatment. Physical exercise was guided by a specialized physical fitness doctor, and nutritionists gave individualized nutritional guidance and formulated nutritional recipes and nutritional meal preparation during the rehabilitation period. During the rehabilitation period, patients keep a daily rehabilitation diary and express their emotions through drawings. In the rehabilitation diary, the patient expressed her emotions and inner demands through a picture called “Shouting Mountain”. The psychologist promptly found the patient for individual counseling, and further communicated with the patient’s family to understand the real cause of the patient’s emotional depression, and gave appropriate guidance, so that the patient’s emotions were quickly improved.
After 3 days of comprehensive TCM treatment, the patient’s appetite improved significantly and the amount of meals gradually increased. She said with a smile, “On the first day of hospitalization, I gave all my sick food to my partner because I couldn’t eat a single bite; on the second day, I had half and he had half; on the third day, I finished most of it and he had to go buy his own food, huh ……” . Through medication, food therapy and physical exercise, the patient’s strength also gradually recovered. She, who originally did not like to go out, requested after a few days of hospitalization to go for a walk in a nearby park and insisted on learning and practicing Guo Lin Qigong together with her patients every day. During the rehabilitation period, the scientific lectures not only answered the patients’ confusion about cancer diseases and satisfied the patients’ and their families’ thirst for knowledge about Chinese and Western medicine treatment, but also taught the patients practical family health care methods, how to select acupuncture points, what points to use under what circumstances and how to operate them. When discharged from the hospital, patients are given specific instructions according to their individual conditions, such as: rubbing the Tai Chong point (which has the effect of calming liver fire and nourishing blood in the liver) when they are emotionally agitated, as well as pressing and rubbing the Hegu point, which has a calming effect on the mind; moxibustion of the Foot San Li, Guan Yuan and Shen Que points to regulate the spleen and stomach (the source of Qi and blood biochemistry) and to cultivate vital energy, which can improve the body’s immune function and increase white blood cells. This can improve the immune function and raise the white blood cells. In addition, according to the psychological assessment done at the time of admission, psychologists visit patients’ bedsides every 2 to 3 days to talk individually and provide targeted individual psychological counseling. The dietitian, knowing the patient’s dietary preferences, formulated a week’s worth of recipes for the patient’s lung and blood deficiency, including breakfast, lunch and dinner, and provided detailed guidance on scientific and reasonable dietary regimen. At the time of discharge from the hospital, the clinician prepared a tonic cream formula for the patient with the main effect of nourishing Qi and Blood to help the body recover by supporting the righteousness, nourishing the deficiency and defending the evil.
After discharge from the hospital, the patient’s partner and daughter gave their full support to the patient’s family’s recovery. With the help of her family, after her discharge from the hospital, Ms. Fu insisted on taking the tumor tonic cream formula and moxibustion health points daily. A nutritionist followed up with the patient by phone to guide her diet. Through comprehensive health care, the patient’s blood picture completely returned to normal after more than 1 month, her meal quantity and weight increased, and her complexion improved significantly. After evaluation by the oncology clinician, the patient was able to continue chemotherapy. In the next few chemotherapy sessions, Ms. Fu was pleased to find that her body was significantly more tolerant to the side effects of chemotherapy, her white blood cells were maintained at about 5000/mm3, and even with a brief period of bone marrow suppression, her white blood cells could quickly return to normal levels. The effect of chemotherapy on appetite was also significantly reduced, and he was no longer “uncomfortable” as before. At last year’s return visit we learned that the patient had completed nine cycles of chemotherapy since attending rehabilitation and was doing well, with a smaller lung lesion on review than before. When we visited the patient again two weeks ago, she was receiving targeted drug therapy, her condition was stable, and her old man was accompanying her to convalesce in the field. Her daughter said, “I wish our family could stay like this ……”
Analysis: When the patient was diagnosed in May 2008, she had already lost the chance of surgery due to mediastinal lymph node metastasis and pleural fluid. Chemotherapy was the most effective treatment available at that time, but due to the side effects of chemotherapy leading to bone marrow suppression and leukocyte reduction, the patient could not continue chemotherapy and had to choose to give up. Through the methods learned in the rehabilitation training, and with the help of his family, the patient returned home and continued to adhere to comprehensive rehabilitation and health care, and his body tolerated chemotherapy better. Thanks to the comprehensive guidance of rehabilitation, the knowledge of psychology, nutrition, exercise and health maintenance helped the patient and his family to pass through the various stages of treatment smoothly.