TCM and Cancer: Part 1 - Surgery By Gabrielle Mathieu, LAc, MSOM Gabrielle Mathieu is a Licensed Acupuncturist, with a graduate degree in Oriental Medicine.She has an undergraduate degree in medical technology and worked in hospitals as a lab technician for 12 years before coming to Oriental Medicine.She integrates both medicines in her Austin Texas practice.

Although the treatment scenarios I present are typical of cancer patients, they can be applied to other types of surgeries as well, and people other than cancer patients can benefit from treatment.

When a patient's cancer is discovered early, the first suggested therapy often will be surgery. The doctors want to remove the tumor as soon as possible. In many cases, a diagnosis of cancer must wait until the surgery, after which the tissue can be examined. Looking at the composition of the removed tumor will also yield additional information about the aggressiveness of the cancer, when the pathology report is complete. The doctor will then recommend about any additional treatment, such as chemotherapy or further surgery.

The site of surgery, of course, depends on the location of the suspected or known cancer. Chinese medicine is an underutilized part of the recovery process. It would not occur to many patients to seek additional help for some of the situations that can come up. Although I have not applied acupuncture to every situation I describe, there are cases in literature and anecdotal evidence for many of the treatments.

Acupuncture and Post-surgical Nausea

Immediately after the surgery, an acupuncture point called Pericardium 6 has been proved in clinical trails to be helpful in the treatment of surgically related nausea and vomiting. If the patient is still hospitalized, she may want to just have a friend or family member press on the point, as it might be difficult to get an acupuncture visit in the hospital. The point is located between the two tendons on the inside of either wrist. Take the other hand and measure the breadth of three of the fingers from the crease of the wrist towards the elbow. A slight hollow or depression corresponds to Pericardium 6.

Moxa and Urinary Retention

Urinary retention can be another problem after surgery. If the patient is on bed rest, the acupuncturist may be able to stop by for a short visit, to see if using a device called a Tiger Warmer could be helpful. The Tiger Warmer, which encases a stick of burning herb called moxa, provides gentle pressure and warmth on a vertical line between the navel and pelvic bone to encourage urination. (A moxa stick can also be used without a Tiger Warmer). A family member or friend can be trained to do this. The important acupuncture points stimulated along the vertical line are known as Ren 3 and Ren 4. Ren 3 has a direct connection with the bladder. This procedure should be avoided if the operation involved abdominal incisions that will be near the area stimulated.

Low Blood Pressure

Another problem that can be encountered post-surgery is low blood pressure. After the administration of strong pain-killers or sedatives, patients might have low blood pressure and dizziness. The dizziness may also cause nausea. A protocol described by Kiiko Matsumoto which might be used by Japanese style acupuncturists uses points from the Pericardium meridian, also known as the Heart Protector meridian, and the Spleen meridian to help normalize blood pressure. Other practitioners may elect to use a point at the crown of the head. Herbal tonics are often useful as well, although the effect will not be immediate.

Scars from Surgery

Scars from operations can interfere with body functions, even those that might seem unrelated. To understand why this is so, let us explore the concept of meridian theory.

A simple explanation, although one that doesn't do justice conceptually, is that meridians are like pathways which transmit information. The meridians arise in organs which govern groups of related functions. These organs don't correlate exactly to Western medical organs, although they bear the same names. Certain meridians that have to do with important body functions such as digestion, (Spleen) the storage and movement of blood, (Liver) and the removal of wastes (Kidney) travel through most of the ventral (front) part of the body. When an incision is made across the flow of information, it results in subtle alteration of the transmission of energetic information. Therefore scars, especially abdominal scars, can create problems. On a physiological, rather than energetic level, improperly healed scars cause adhesions, and restriction of blood flow, which can result in compression of various organs or nerves.

After the operation, while the scar tissue is forming, a practitioner can use distal points (points closer to the hands or feet) on the meridian to keep the meridian functioning properly. For example, let us say that an abdominal scar traverses the Spleen meridian. While the abdominal area would not be treated after the operation, the points on the shin and knee, which are also part of the Spleen meridian, could be treated. The practitioner can also calm inflammatory reactions by using special points, called Metal and Water points, to reduce inflammation.

Incisions from major operations may take 1 to 3 months to go through the process of scar formation. While the scar as healing, after you have been approved to take showers, the acupuncturist may recommend a liniment. Certain liniments contain herbs that move blood and encourage local circulation. Once the scar is completely formed, your acupuncturist may decide to treat it directly, in addition to treating the distal points on the meridians. Scars that are unusually thick, or reddened and raised, indicate a local disturbance in the tissue. Numbness or pain are other another indications for treatment. The scar can be treated by the indirect application of moxa, as well as by direct needling.

Post-surgical Lymphedema

Another disturbance that can arise from cancer surgery is lymphedema, a swelling of the arm or leg, subsequent to the removal of lymph nodes. Women with breast cancer have these lymph nodes checked in many cases. Lymph nodes are removed for examination when the doctor suspects cancer may have spread. Doctors believe that lymphedema is more likely to occur if the affected side is disturbed by pressure or an incision, and the patient is instructed to avoid blood pressure cuffs and blood draws in that area. In most cases, that means no acupuncture needles as well, If the arm becomes swollen despite precautions, there are useful points in other areas which can be needled to restore lymphatic circulation, such as the back of the shoulder. Light application of an Asian bodywork technique, such as Shiatsu, can also be helpful. Massage that uses vigorous rubbing and kneading should be avoided, unless the therapist has received specific instructions on how to do lymphedema massage. If the patient has healed from surgery, she may also be instructed on how to do some gentle exercises, such as Qi Gong, to restore energy into the circulation.

For many cancer patients, surgery is just the first step in treatment. In the next article, I will be discussing chemotherapy and Traditional Chinese Medicine's role in treating side effects.