Causes of Cancer and How Traditional Chinese Medicine Practitioners Diagnoses Cancer

 

Professor Liu Yulong
Clinical Professor of Chinese Medicine, School of Chinese Medicine, Hong Kong Baptist University

 

Information Compilation : Ms. Bernadette Cook, Ms Rita Liaw; Ms Kitty Au Yeung

 

 

 

Introduction: Many cancer patients in Hong Kong want to receive traditional Chinese medicine treatment while seeing doctors, but they have little basic understanding of traditional Chinese medicine treatment, which makes them a little worried. In this article, Professor Liu Yulong explains to us how traditional Chinese medicine views the causes of cancer from a macro perspective and how traditional Chinese medicine practitioners diagnose and treat cancer.

Part One - Macro View of the Causes of Cancer
Part Two - Pathogenesis of Cancer
Part Three - How Traditional Chinese Medicine Practitioners Diagnose Cancer
Part Four - Prognosis of Cancer Toxins and Tumors

 

Part One - Macro View of the Causes of Cancer

The causes of cancer can be analyzed from three perspectives: "internal causes", "external causes", and "neither internal nor external causes":

(I) Internal Causes（內因）

Constitutional Reasons

A person's innate constitution can affect the chance of getting cancer:

• Inborn Abnormality（稟賦異常） - If a person has a family history of cancer, they may have a higher chance of getting cancer, such as breast cancer, ovarian cancer;
• Inborn Deficiency（稟賦不足） - For example, for people with congenital genetic defects, the chance of getting a tumor can increase; and
• Phlegm-damp constitution（痰濕體質） - that is, obese constitution, the chance of getting some cancers is higher, such as breast cancer, pancreatic cancer.

Personality and Emotional Type

A person's mental state can also affect the chance of getting cancer.

If a person is chronically depressed (anger, worry, thought, sadness, fear)(怒、憂、思、悲、恐), they will have a higher chance of getting some cancers, such as liver cancer, thyroid cancer, and breast cancer.

(II) External Causes（外因）

Unrestrained and unclean diet（飲食不節、不潔）

Poor eating habits can increase the chance of getting some cancers:

・Unrestrained（不節）: partial eating (too much, too little, unbalanced nutrition); love of greasy and heavy flavors, alcohol; too much red meat; too little cellulose (less fruits and vegetables), may lead to some cancers, such as colorectal cancer, stomach cancer and breast cancer; and

・Unclean（不潔）: Pickled food (containing carcinogenic nitrites); moldy food (containing carcinogenic aflatoxins); and smoked and grilled food, all of which may cause certain cancers, such as liver cancer, esophageal cancer, and stomach cancer.

In places with poor environment, such as contaminated food and water, people also have a higher chance of getting cancer (for example, chemical factory pollution).

Six Evils (wind, cold, heat, dampness, dryness, fire)（六淫（風寒暑濕燥火））

The "Six Evils" can also be said to be environmental factors:

・The "Six Evils" refer to "wind, cold, heat, dampness, dryness, fire". In modern terms, it refers to abnormal environmental climate changes that are prone to cause human diseases (including too much, not enough, early or late seasonal climate changes);

・Heat (fire) or sunbathing can cause skin cancer; and

・Damp heat: In South China, Guangdong, Guangxi, Hunan, Fujian, Hong Kong, Macau, etc., due to the damp and hot climate suitable for the growth of nasopharyngeal EB virus, the incidence of nasopharyngeal cancer among citizens is higher.

External toxins（外界邪毒）

This is similar to what modern people call environmental pollution:

・Smoking and passive smoking (second-hand smoke) - increase the chance of getting the following cancers: lung cancer, bladder cancer, oral cancer, throat cancer;

・Small household air pollution (poor ventilation) - cooking oil fumes, renovation pollution (glue, paint, new chemical materials), stone (such as marble, granite, etc.) radiation can increase the chance of getting the following cancers: lung cancer, leukemia, lymphoma;

・Factory (pollution) - coal mines, etc., increase the chance of getting lung cancer; and

・Foggy days

Air (smog) - severe air pollution, etc., increases the chance of getting lung cancer.

(III) Non-internal and external factors（不內外因）

These mainly include "lifestyle diseases" or bad living habits:

・Fast pace of life;

・Lack of exercise;

・Staying up late/night and day upside down;

・Mental work pressure exceeds capacity; and

・Fatigue (mental fatigue, mental work pressure, physical labor).

Part Two - Cancer Pathogenesis

The "pathogenesis"（病機） (or disease mechanism and process) of a person's cancer can be explained as follows:

(1) The generation/existence of various causes of disease:

Internal cause - for example, insufficient endowment, deficiency of vital energy; or extremely negative emotions;

External cause - for example, external toxins (severe air pollution);

Non-internal and external factors - for example, excessive mental work pressure, physical labor.

(2) The above-mentioned causes of disease enter the human body through the skin, hair, mouth, and nose, damaging the organs, meridians, qi, and blood;

(3) The damage to the organs by the disease, the meridians, qi, and blood lead to the following pathological products, such as qi stagnation, blood stasis, phlegm dampness, heat toxins, cancer toxins;

(4) The above-mentioned pathological products do not disperse for a long time and condense into cancer lumps - producing "primary focus symptoms"（原發灶症狀）;

(5) The struggle between the righteous and the tumor (the struggle between the righteous qi and the tumor) （正瘤相爭）- phlegm, blood stasis, and toxins, transferred through the "meridians";

(6) Transfer focus（轉移灶） (the place of transfer is where the patient is "most deficient") - producing "transfer focus symptoms"（轉移灶症狀）; and

(7) Further transfer to the whole body - producing "whole body symptoms"（全身症狀）.

Part Three - How Traditional Chinese Medicine Practitioners Diagnose Cancer

Basic principles

So how does traditional Chinese medicine analyze cancer conditions or tumor properties?

There are mainly two principles - "deficiency of the root"（本虛） and "excess of the mark"（標實）.

"Deficiency of the root"（本虛）

This is to clearly understand what problems the patient's five organs and six viscera have, including the deficiency of the organs and meridians, and the insufficiency of qi, blood, yin, and yang.

How to analyze "deficiency of the root" in detail: "deficiency of the organs, meridians, qi, and blood"(臟腑經絡氣血虧虛)

This includes the following steps:

1. First, understand the patient's disease characteristics (cold and heat) to understand the patient's disease nature(臟腑和病位):

Deficiency category	Symptoms
Qi deficiency	Functional decline (shortness of breath, laziness, fatigue, etc.)
Blood deficiency	Anemia and pale face
Yin deficiency	Dry mouth and hot flashes
Yang deficiency	Fatigue and fear of cold

2. Then understand the problematic "organs" (臟腑) and "disease locations"(病位／臟腑開竅):

Organs	Disease location / Organ opening
Heart	Chest (palpitations) / Tongue
Liver	Flank (pain) / Eye
Spleen	Abdomen (diarrhea) / Mouth
Lung	Chest (cough and asthma) / Nose
Kidney	Waist (pain) / Ear, two yin

For example, a patient with the following symptoms: waist pain (disease location in the kidney)（腰痛（病位在腎）, fatigue and fear of cold (yang deficiency)（倦怠怕冷（陽虛））, is diagnosed as: kidney yang deficiency（腎陽虛）.

Also, for example, with the following symptoms: flank pain (disease location in the liver)（脅痛（病位在肝））, dry mouth and hot flashes (yin deficiency)（口乾潮熱（陰虛））, is diagnosed as liver yin deficiency（肝陰虛）. In short, combine the category of deficiency with the disease location of the organs to make an accurate diagnosis.

3. The five organs are closely related to the five senses and nine orifices of the human body, such as the heart opening to the tongue, and the liver opening to the eyes, etc. For example, dry eyes (disease location in the liver), flank pain (disease location in the liver), dry mouth and hot flashes (disease nature yin deficiency), TCM diagnosis: liver yin deficiency.

After studying all aspects, the TCM doctor can diagnose the patient - for example: lung and kidney yin deficiency, lung and spleen qi deficiency.

"Excess of the mark"(標實)

This is when a large amount of waste has accumulated in the body and needs to be removed, which is "detoxification" （攻毒/排毒)。

The waste in the body includes: cancer toxins, accumulated toxins, phlegm turbidity, blood stasis, dampness, heat toxins, wind evil, cold dampness, damp heat, etc.（癌毒，蓄毒，痰濁，瘀血，水濕，熱毒，風邪，寒濕，濕熱等。）．

Here are explanations of a few common problems:

(1) Cancer toxins（癌毒）

Characteristics and features of cancer toxins:

・Easy to grow;

・Its nature is fierce, consuming qi and blood essence, damaging the function of organs and blood;

・Easy to invade and spread;

・Easy to coagulate with blood stasis and phlegm turbidity;

(2) Qi stagnation and blood stasis（氣滯血瘀）

・Various factors affect the normal operation of qi or blood, leading to qi stagnation and blood stasis, long-term accumulation and non-dispersion, causing local tissues to accumulate and gradually form tumors;

・Characteristics: pain + tumor + bruise (skin) + tongue image (bruise) / pulse image (fine astringent)（疼痛+腫塊+瘀斑（皮膚）+舌象（瘀斑）／脈象（細澀））;

(3) Phlegm condensation and dampness accumulation（痰凝濕聚）

・Due to the impact on the function of organs and blood, the distribution of body fluids is abnormal, the body's water and dampness condense, accumulate into damp toxins over time, and then are scorched by evil fire, condensing into phlegm;

・Jin Yuan, Zhu Danxi （金元，朱丹溪）believed that "all lumps on, in, and under the human body are mostly phlegm"（凡人身上、中、下有塊者多是痰）, phlegm and dampness rise and fall with qi, phlegm stagnation is everywhere, causing pathological changes;

・Characteristics: painless tumor + enlarged lymph nodes + phlegm drink (cough phlegm) + tongue image fat and greasy / pulse image string slip（無痛腫塊+淋巴結腫大+痰飲（咳痰）+舌象胖大苔膩／脈象弦滑）;

(4) Heat toxin internal accumulation（熱毒內蘊）

・Depression and heat evil accumulate over time, transforming into heat toxins, heat toxins accumulate internally, and interact with phlegm, dampness, and blood stasis, deeply rooted in the organs and tissues, difficult to clear, forming the complex disease condition unique to cancer, promoting its widespread invasion, and changing in many ways; and

・The above various pathological changes do not exist alone, they are often two or several kinds of coexistence or cross appearance.

・Characteristics: cancerous ulcers (body surface / body) + tongue red and yellow + pulse image slip number（癌性潰瘍（體表／體內）+舌紅苔黃+脈象滑數）.

Comparison of tumor diagnosis in Chinese and Western medicine

Compared with Western medicine's use of clinical examinations (including questioning / seeing, touching, knocking, listening) plus laboratory, imaging examinations, and live tissue examinations to locate, qualify, and stage cancer, Chinese medicine uses "four diagnoses"（四診）: "looking, smelling, asking, and palpating " （望、聞、問、切）to do:

• "Disease differentiation" (disease name, disease location, disease stage)（辨病」（病名、病位、病期））; and
• Syndrome differentiation (deficiency of the root and reality of the mark)（辨證（本虛標實））.

Traditional Chinese medicine and Western medicine each have their strengths. Traditional Chinese medicine has a long history and rich experience, while Western medicine is based on the scientific foundation of "evidence-based medicine". Nowadays, many traditional Chinese medicine practitioners refer to the scientific evidence of Western medicine's laboratory tests and imaging tests in the process of diagnosing and treating patients, hoping to make more accurate and comprehensive diagnoses and treatments for patients.

Below is a comparison of the methods used by traditional Chinese medicine and Western medicine in diagnosing cancer:

	Traditional Chinese Medicine	Western Medicine
Four Diagnoses	Inquiry/Inspection, Auscultation and Olfaction, Pulse-taking and Palpation	Inquiry/Visual, Tactile, Percussion, Auscultation + Laboratory, Imaging, Biopsy
Diagnosis	Disease Name + Syndrome Type + Disease Stage/Progression + Order/Inverse	Disease Name + Pathology/Genetics + TNM Staging + Prognosis
Cause of Disease	Constitutional Abnormality + Chronic Disease/+ Pathogenic Factors + Long-term Emotional Disorder	Genetic Predisposition + Chronic Disease/+ Environment (Physical, Chemical, Biological Factors) + Continuous Mental Stress
Pathogenesis	Accumulation of Toxins/Internal Deficiency of Vital Energy (Lung, Spleen, Kidney Deficiency)	Formation of Cancer Cells/Genetic Mutation/Immune Evasion Surveillance
Development	Accumulation of Toxins Forming Masses Internally	Uncontrolled Growth of Cancer Cells Forming Masses
Metastasis	Accumulation of Toxins, Phlegm and Stasis Interacting/Transmission	Cancer Thrombus/Lymphatic, Blood Spread
Prognosis	Cure, Latent Pathogenic Factors, Deterioration	Cure, Dormancy/Stability, Deterioration

 

Part Four - Prognosis of Cancer and Tumors

Once cancer is formed, the rise and fall of the power of cancer and the body's vital energy (resistance to disease) determine the prognosis of the tumor:

• Strong vital energy, cancer is eliminated, disease is improving;
• The power of cancer and vital energy is temporarily balanced, cancer is in a dormant state (at this time, cancer is also called "latent pathogenic factors"); and
• The invasive power of cancer is greater than the body's anti-cancer power, then cancer and phlegm stasis interact and flow, metastasizing to the weakest part of the body, forming metastatic foci (cancer drug metastasis rule), cancer worsens.

In other words:

Cancer - Comparison of Vital Energy Power（正氣力量對比）

• Vital Energy > Cancer: Improvement or Cure
• Vital Energy < Cancer: Deterioration/Spread Metastasis
• Vital Energy = Cancer/Power Balance: Cancer Dormancy/Living with Tumor

(December 2021)