Herbal treatment during radiotherapy

  Radiotherapy is a double-edged sword, which can quickly and effectively contain cancer cells, but can also cause damage to the already riddled patient’s body. Its side effects include: bone marrow suppression, nausea and vomiting, hair loss, fatigue, mouth ulcers, diarrhea and constipation, neuromuscular numbness, etc. Clinical evidence shows that Chinese medicine can effectively alleviate the adverse effects caused by radiotherapy, improve the patient’s quality of life and prolong survival time.  1, the effect of Chinese medicine to raise the blood image lasting radiotherapy will cause bone marrow suppression, bone marrow produces three important blood components: red blood cells that deliver oxygen to the body’s cells; white blood cells that resist infection; platelets that help blood clotting and hemostasis. Chemotherapy destroys bone marrow cells, which reduces the number of blood cells produced. The decrease in the number of each type of blood cell can cause specific side effects.  Chinese herbs that raise white blood cells include: Astragalus, Radix Codonopsis, Poria, Radix et Rhizoma, Cuscuta, Semen, Radix et Rhizoma bitter, Radix et Rhizoma raw and ripe, Yam, Ginseng, Ganoderma, Zingiber officinale and Gynostemma. Herbs that raise red blood cells include: Astragalus, Agaricus, Dried Red Date, Angelica, Xian Ling Spleen, Boneset, etc. Platelet-raising herbs include: peanut coat, Shangluo, etc. There are also some Chinese patent medicines such as compound Agaricus blazei, blood-raising nectar, and Wuji Baifeng Pill, etc. all have blood-raising effects. A large number of clinical evidence, although the speed of Chinese medicine to raise the blood image is slow, it takes about a week, but once the blood image is up, it is maintained for a long time.  Nausea and vomiting are the most common early side effects of radiotherapy and chemotherapy. About 60% of chemotherapy patients have nausea and vomiting, which can cause dehydration, electrolyte imbalance, weakness and weight loss, which greatly reduces the survival quality of tumor patients and may make them refuse to receive effective treatment and affect the successful completion of normal chemotherapy cycle. Vomiting is classified into acute vomiting, which usually occurs within 24 hours after chemotherapy; delayed vomiting, which occurs within 5-7 days after 24 hours of chemotherapy; and anticipatory vomiting, which is a conditioned reflex in which the patient experiences vomiting during the first chemotherapy and becomes nauseous and vomits before the next chemotherapy. Clinical studies have confirmed that the use of TCM in chemotherapy can improve patients’ gastrointestinal function, reduce the toxic side effects of chemotherapy drugs, effectively prevent and relieve vomiting symptoms, thus improving patients’ quality of life during chemotherapy and increasing patients’ tolerance to chemotherapy.     Chinese medicine believes that the key pathogenesis of chemotherapy-induced nausea and vomiting lies in the damage to the spleen and stomach caused by the chemical drugs, the loss of harmony in the middle jiao, and the imbalance of qi flow. Therefore, the main treatment is to strengthen the spleen and stomach, regulate the qi flow, lower the rebellion and stop vomiting. From the current clinical point of view, there are many methods of Chinese medicine to prevent and treat chemotherapy-induced nausea and vomiting, including internal treatment, external treatment, acupuncture and moxibustion therapy, and diet therapy. Chinese medicine mainly uses drugs with the effect of strengthening the spleen and stomach and moving qi, such as Xiang Sha Liu Jun Zi Wan, Ginseng and Bai Zhu San, Bao He Wan, etc., while tonics need to be treated according to the evidence. At present, our department also prepares its own anti-vomiting formula for acupuncture point compressing with chemotherapy to stop vomiting, which has good clinical effect.  (1) Fatigue: Fatigue is one of the most common side effects of radiotherapy, which can cause mental discomfort in light cases and exhaustion in heavy cases. Especially at the beginning and end of chemotherapy, it is the most serious. We can reduce the fatigue symptoms caused by chemotherapy by applying qi-supplementing herbs such as Radix et Rhizoma Ginseng and Radix Astragali.  (2) Hair loss: Hair loss (alopecia areata) can ruin one’s mood. Not all chemotherapy drugs cause hair loss, and some people’s hair becomes just a little thinner. Your doctor will tell you if your hair loss is caused by chemotherapy. Most hair loss caused by chemotherapy will grow back after the chemotherapy is over. Some young people or women who require this can use blood nourishing and hair regenerating medicines, such as yellow essence and he shou wu, so that patients can grow their hair as early as possible.  (3) Dry mouth: The most common side effect of radiotherapy is dry mouth, which is believed by Chinese medicine to be caused by radiation injuring fluid and burning lung yin.  (4) Constipation and diarrhea: some chemotherapy drugs such as vincristine can cause constipation, and some chemotherapy drugs such as elitecan or lower abdominal radiotherapy can damage the intestinal mucosa cells, resulting in diarrhea, and if accompanied by enteritis, diarrhea will also aggravate. Chinese medicine is also very effective in the treatment of constipation or diarrhea, such as the treatment of constipation can be used to fire marijuana, Yu Li Ren, rhubarb, raw earth, He Shou Wu, etc., the treatment of diarrhea can be used to Wu Wei Zi, Wu Mei, dogwood, etc.  (5) Mouth ulcers: During radiotherapy and chemotherapy, tumor patients often have recurrent mouth ulcers due to the decrease of patients’ resistance and immune function, so we can treat mouth ulcers with watermelon cream, Liushenwan, Yunnan Baiyao, etc.  4.There are principles of TCM attack and supplementation. When treating tumors with TCM, there are two principles that need extra attention: (1) To correctly grasp the timing of supporting the righteous and dispelling the evil. Chinese medicine treatment is about supporting the righteous and dispelling the evil. To help the righteous is to guard, and to dispel the evil is to attack. During chemotherapy, you should only guard, not attack. Because the patient’s resistance is weak at this time, only drugs to nourish the qi and blood, strengthen the spleen and stomach can be used to support the righteousness. If drugs to clear heat and detoxify the blood and activate blood circulation are used to attack the cancer cells, it will only aggravate the damage to the patient’s body. After the completion of radiotherapy, if the patient is in good condition, Chinese medicine can be used to control the recurrence and metastasis of tumor. Therefore, patients should not take the so-called “ancestral secret recipes” at will, but should receive standardized TCM treatment in regular hospitals.  (2) Overall conditioning, tonics are the most suitable. Patients have not one but many kinds of side effects after chemotherapy, therefore, when solving the side effects, it is necessary to regulate the patient as a whole. In addition to adult medicine, specific to each cancer patient, the damage caused by side effects varies, some patients will have liver, kidney and nerve damage, as well as radioactive pneumonia, etc. It is best to follow the principle of individualization when using medicine and treat with evidence, and tonics are the most suitable.  In conclusion, Chinese herbal medicine for cancer treatment is a unique and valuable medical heritage of China. Thousands of years of Chinese culture have accumulated rich experience in Chinese herbal medicine for cancer treatment. If some Chinese herbal medicines are taken at the same time during radiotherapy, it can adjust the overall nutritional imbalance of the patient, restore and improve the patient’s resistance, and achieve the effect of synergistic chemotherapy drugs against cancer, so that the patient can finish chemotherapy more smoothly and steadily.