Integrative Treatment of Breast Cancer
Combining Traditional Chinese Medicine and Western Medicine

 

Yu-Ting Su, M.D., Ching-Mao Chang, M.D., Ph.D.

 

Director/Attending physician (M.D.) of Division of Integrative Medicine, Center

for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

 

Symptoms and Early Warning Signs of Breast Cancer

<Cite: https://cytecare.com/blog/breast-cancer/breast-cancer-symptoms-and-early-warning-signs/>

 

 

The Stages of Breast Cancer

<Cite: https://www.facs.org/for-patients/home-skills-for-patients/breast-cancer-surgery/breast-cancer-types/breast-cancer-staging/>

 

Overview

According to the Cancer Registry Report for 108 years issued by the Ministry of Health and Welfare in Taiwan, the number of newly diagnosed female breast cancer cases was 14,856, ranking first in the incidence of female cancer in Taiwan [1]. Based on the 110-year mortality statistics released by the Ministry of Health and Welfare, 2,913 women died of breast cancer, second only to lung cancer in terms of female cancer mortality rates [2]. Therefore, breast cancer poses a significant threat to women's health in Taiwan.

 

 

<Cite: Traditional Chinese medicine mediated tumor suppression via regulating psychological factors. Medicine in Novel Technology and Devices. 16:100162, 2022>

 

Features

Current breast cancer treatments include surgery, radiotherapy, chemotherapy, endocrine therapy, targeted therapy, immunotherapy, etc. Although these treatments have improved the survival rate of breast cancer patients, they also cause negative effects on the body and mind, such as infertility, osteoporosis, depression, anxiety, sleep disorders, fatigue, premature ovarian failure, and sexual dysfunction [3, 4]. Patients who are physically and mentally exhausted after cancer diagnosis may seek complementary and integrative medicine (CIM) to alleviate discomfort and improve their quality of life [5, 6].

 

 <Cite: Traditional Chinese medicine and cancer: History, present situation, and development. Thorac Cancer. 2015 Sep;6(5):561-9>

 

Procedure

In Taiwan, CIM is mainly based on Traditional Chinese Medicine (TCM). Recently, there have been evidence-based medical articles on the involvement of TCM in the conventional treatment of breast cancer as one of the treatment options. A retrospective population-based cohort study using the Taiwan National Health Insurance Research Database from 2001 to 2010 showed that TCM treatment can improve the survival rate of patients with advanced breast cancer [7]. Acupuncture therapy in TCM can reduce pain severity, stress levels, and improve life satisfaction and emotional state in patients with advanced breast cancer when assessing their quality of life [8].

 

<Cite: Advances in Molecular Mechanisms for Traditional Chinese Medicine Actions in Regulating Tumor Immune Responses. Front Pharmacol. 2020>

 

Notification

Although there is no specific term for breast cancer in ancient Chinese medicine, ancient literature classified it as "Ru Yan" or "Ru He." It was believed that emotional trauma was the leading cause of breast cancer development. Emotional hyper- or hypo-activity and Liver Qi stagnation lead to stagnation in the stomach, liver, and gallbladder meridians, forming phlegm masses. Insufficient Qi and Blood can also aggravate Qi Stagnation and Blood Stasis, leading to breast cancer [9]. Modern research suggests that breast cancer is related to factors such as age, genetics, and hormone replacement [10]. The China Medical University Hospital in Taiwan analyzed TCM clinical medical records and found that the main TCM patterns for breast cancer are Liver and Gallbladder Damp-Heat, followed by Liver Depression transforming into Fire, Damp-Toxin Soaking, Liver and Kidney Yin Deficiency, Liver Depression with Spleen Deficiency, and Qi Deficiency with Blood Stasis [11]. The top ten commonly used TCM herbal formulas for breast cancer include Jia Wei Xiao Yao San, Xiang Sha Liu Jun Zi Tang, Gui Pi Tang, San Zhuo Kui Jian Tang, Bu Zhong Yi Qi Tang, Tian Wang Bu Xin Dan, Ban Xia Xie Xin Tang, Suan Zao Ren Tang, Ren Shen Yang Rong Tang, and Xue Fu Zhu Yu Tang. These prescriptions have various effects such as clearing heat, detoxifying, resolving dampness, tonifying deficiency, and transforming stasis, corresponding to different treatment patterns [12].

TCM interventions not only improve cancer-related fatigue in breast cancer patients [13], but also alleviate post-chemotherapy side effects such as nausea, vomiting, diarrhea, hair loss, bone marrow suppression, and immune dysfunction [14]. Combining radiotherapy with TCM treatment can enhance the radio-sensitizing effect of radiotherapy and reduce its side effects [15]. When combined with endocrine therapy, TCM can improve bone density, menopausal symptoms, pain, and immune dysfunction, while acupuncture can alleviate hot flashes and night sweats [16, 17]. In the case of triple-negative breast cancer, studies have shown that TCM can regulate the body's immune function to inhibit cancer cell proliferation and metastasis, and modulate tumor-related signaling pathways, achieving the goal of adjuvant therapy [18].

With the joint efforts of both TCM and Western medicine in cancer treatment, we can expect the threat of breast cancer to women's health to decrease progressively, allowing women with cancer to achieve relatively high-quality stability in their physical, mental, and emotional well-being.

 

Reference

1.     衛生福利部國民健康署, 108年癌症登記報告. 2022.04.17.

2.     衛生福利部統計處, 110年死因統計結果分析(含附表). 2022.06.30.

3.     Burguin, A., C. Diorio, and F. Durocher, Breast Cancer Treatments: Updates and New Challenges. J Pers Med, 2021. 11(8).

4.     Ewertz, M. and A.B. Jensen, Late effects of breast cancer treatment and potentials for rehabilitation. Acta Oncol, 2011. 50(2): p. 187-93.

5.     Sewitch, M.J., et al., Use of complementary and alternative medicine by cancer patients at a Montreal hospital. Integr Cancer Ther, 2011. 10(4): p. 305-11.

6.     Wode, K., et al., Cancer patients' use of complementary and alternative medicine in Sweden: a cross-sectional study. BMC Complement Altern Med, 2019. 19(1): p. 62.

7.     Lee, Y.W., et al., Adjunctive traditional Chinese medicine therapy improves survival in patients with advanced breast cancer: a population-based study. Cancer, 2014. 120(9): p. 1338-44.

8.     Dean-Clower, E., et al., Acupuncture as palliative therapy for physical symptoms and quality of life for advanced cancer patients. Integr Cancer Ther, 2010. 9(2): p. 158-67.

9.     林健蓉、謝宗運、張慈文, 乳癌之中西醫病機與預防. 中醫藥雜誌 28卷2期, 2017. 12: p. 11 - 27.

10.   Feng, Y., et al., Breast cancer development and progression: Risk factors, cancer stem cells, signaling pathways, genomics, and molecular pathogenesis. Genes Dis, 2018. 5(2): p. 77-106.

11.   Huang, W.T., et al., Application of Neural Network and Cluster Analyses to Differentiate 中醫藥 Patterns in Patients With Breast Cancer. Front Pharmacol, 2020. 11: p. 670.

12.   Lai, J.N., C.T. Wu, and J.D. Wang, Prescription pattern of chinese herbal products for breast cancer in taiwan: a population-based study. Evid Based Complement Alternat Med, 2012. 2012: p. 891893.

13.   Deng, S.M., et al., Association between cancer-related fatigue and traditional Chinese medicine body constitution in female patients with breast cancer. J Tradit Complement Med, 2021. 11(1): p. 62-67.

14.   Li, S., et al., Chinese Herbal Medicine for Reducing Chemotherapy-Associated Side-Effects in Breast Cancer Patients: A Systematic Review and Meta-Analysis. Front Oncol, 2020. 10: p. 599073.

15.   Xiang, Y., et al., Traditional Chinese medicine as a cancer treatment: Modern perspectives of ancient but advanced science. Cancer Med, 2019. 8(5): p. 1958-1975.

16.   Li, L., et al., Evidence on Efficacy and Safety of Chinese Medicines Combined Western Medicines Treatment for Breast Cancer With Endocrine Therapy. Front Oncol, 2021. 11: p. 661925.

17.   de Valois, B.A., et al., Using traditional acupuncture for breast cancer-related hot flashes and night sweats. J Altern Complement Med, 2010. 16(10): p. 1047-57.

18.   Zhao, W., et al., Immune Effect of Active Components of Traditional Chinese Medicine on Triple-Negative Breast Cancer. Front Pharmacol, 2021. 12: p. 731741.