Unconventional Paradigm of Etiopathogenesis of Cancer in Oriental Medicine Oncology
Complementary & Alternative Medicine, Department of Veterinary Clinical Sciences, Veterinary Medical Center, College of Veterinary Medicine, University of Minnesota, MN, USA
Cancer is neither a new emerging disease nor a modern ailment in Oriental Medicine oncology. The word tumor (Aam in Korean, Liu in Chinese) was found on an oracle bone in the Yin dynasty (BC 1700–1100) and has been cited in several classical books and references. Aam or Liu in Oriental Medicine oncology is described as a hard mass or irregular form of phlegm accumulation in the body. Although there is no medical terminology like cancer and no clear distinction between malignant and benign tumors in Traditional Oriental Medicine, certain clinical manifestations are similar to those of cancer or tumors in conventional oncology.
The etiopathogenesis and characteristics of various tumor types such as Ru Yan (breast cancer), Shen Yan (kidney cancer), Fan Hua (skin cancer), Fan Wei (stomach cancer), and Can Chun (oral carcinoma) were elucidated in the "Dong Eui Bo Gam"(AD1500)2, which was written by Dr. Hur Jun during the Josun dynasty in Korea. In this book, he also described treatment strategies for each type of tumor including dietary therapy and medicinal herbs.2
The concept, etiology, and pathogenesis of cancer in Oriental Medicine oncology are different from those in conventional oncology. The definitive etiopathogenesis for cancer in conventional oncology is not available. However, pattern differentiation of each patient would make it possible to elucidate etiopathogenesis of cancer patients in Oriental Medicine oncology.
Several medical modalities including medicinal herb therapy, dietary therapy, moxibustion, Chu-na (Tui-na) and acupuncture treatment have been applied as empirical treatment options to manage clinical signs as well as underline patterns of cancer. Many herb formulas have been investigated not only for alleviating side effects from conventional therapy but also for treating cancer. Although acupuncture therapy is not selected preferentially as a leading option in modern Oriental Medicine oncology, it has been applied as a complementary therapy for alleviating the cancer-related pain or side effects generated from conventional therapies. Lately, controversial reports on Oriental Medicine cancer treatments have been considered due to the lack of scientific evidence based on Western medicine concepts. However, Oriental Medicine oncology has recently become an eminent option to cancer care in the mainstream medical community. Complementary medicine for cancer therapy has increased substantially, and the integration of Oriental Medicine and Western medicine will lead to better options for cancer patients.1
Etiopathogenesis of Cancer in Oriental Medicine Oncology
Cancer is one of the leading causes of mortality showing over thirty to forty percent of the incident rate in small animals. Animals can get various types of cancer. Tumor biology and carcinogenesis in animal oncology are similar to human beings. In Western medicine, from the oncology perspective, the tumor is the product of uncontrollable cell growth that multiplies beyond the death rate of cells. A complicated process accomplishes this uncontrollable cell growth. There are two types of neoplastic transformations: hereditary and sporadic. Although cancer is a hereditary genetic disease, cancer genes are responsible for 5% of cancer outbreak, and the other 95% develops cancer sporadically during the lifetime. The acquired gene mutation could be triggered by microbes (tumor virus, parasite, fungus, bacteria), environmental contamination (chemicals, heavy metals, radiation, ultraviolet radiation), or an inappropriate lifestyle including an unhealthy diet, irregular life patterns and emotional stress. However, etiology and pathogenesis of cancer are not clearly clarified yet in conventional medicine.
In Oriental Medicine oncology, the word tumor (Aam) is most likely based on etiology and is a mass or lump formation in the body due to pathogenic accumulation of Qi, Phlegm or Blood stagnation.
Common etiological factors in Oriental Medicine oncology can be categorized into two parts: external or internal factors. External factors are the primary or secondary triggers for cancer.
Exogenous Carcinogenic Factors
Prolonged exposure to six pathogenic factors is the primary or secondary trigger for cancer in Oriental Medicine. The six pathogenic factors are Wind, Cold, Dampness, Dryness, Fire and Heat.
1. Wind: Wind is a Yang pathogenic factor and the prime guide for other pathogenic factors, which would attack the upper part of the body, or the whole body.
2. Cold: Cold is a Yin pathogenic factor and easily damages the Yang Qi.
3. Dampness: Dampness is a Yin pathogenic factor and easily damages Yang Qi and blocks the Qi passages.
4. Dryness: Dryness is a Yang pathogenic factor and easily damages body fluid.
5. Fire: Fire is an extreme Yang pathogenic factor, easily scorches fluid and generates wind stirring the blood. Tumor triggering microorganisms, prolonged exposure to chemicals and heavy metals will be categorized into toxic Fire.
6. Heat: Heat is a Yang pathogenic factor and easily damages fluid and consumes the Qi.
Endogenous Carcinogenic Factors
Endogenous carcinogenic factors either from the innate constitution or adopted constitution are the underlying causes for cancer and can be exaggerated by external or internal pathogenic factor(s). Prolonged emotional stress or an inappropriate diet are also common trigger factors for cancer. However, Qi deficiency is accounted as a primary predisposed condition for cancer outbreak in Oriental Medicine. Therefore, boosting Zheng Qi is the primary consideration to manage and overcome cancer.3
1. Deficiency of Qi: Qi deficiency is the fundamental cause of cancer that leads ultimately to Blood deficiency. Prolonged deficiency of Qi, blood, or both would weaken individual defense system and eventually result in the stagnation of Qi and Blood.
2. Imbalance of Yin/Yang:Yin and Yang are bipolar energy, which are the fundamental backbone of the body system. The body is constantly working to keep homeostasis between Yin and Yang. The imbalance of homeostasis of Yin and Yang would be an etiopathogenic factor for cancer.
3. Imbalance of Zang-Fu organs: Six Yin (Zang)organs and six Yang (Fu) organs have a close interrelationship with each other. Yin organs store essence and Qi. The six yang organs transform and digest but not store. The imbalance in or among Zang-Fu organs might affect neuro-endocrine system as well as immune system. Therefore persisting imbalance condition would eventually cause the generation of tumor.
4. Emotional strain: Emotion arises from external stimuli or intrinsic factors of individuals. Seven types of emotions including joy, anger, worry, pensiveness, sadness, fear and fright arise constantly in the body as a result from reactions to external or internal trigger factors. Protracted emotional response can cause the imbalance of Zang-Fu organs directly or indirectly.
Dietary therapy in Oriental Medicine is a core medical option for cancer therapy. Dietary therapy could be based on five-phase theory, SaSang Constitutional theory, or pattern differentiation. SaSang Constitutional theory is classified into four main constitutions based on mind, body, activity and matter of individual, and emphasized the food therapy based on individual constitution for prophylactic as well as for therapeutic purpose.4 The dietary therapy based on SaSang constitution has been applied for cancer prevention and therapy in Korea for more than 200 years.
Pattern Differentiation of Cancer in Oriental Medicine
Pattern differentiation in Oriental Medicine is a unique and powerful diagnostic medical modality. In conventional oncology, cancer can be categorized based on origin, staging, and types. In general, pattern differentiation in cancer types in Oriental Medicine can be categorized largely into four groups including (1) Toxic Heat/Fire, (2) Phlegm-heat accumulation; or Phlegm-damp-heat accumulation, (3) Qi/Blood stasis, and (4) Depletion of Yin or essence. The treatment for cancer patients should be considered their pattern differentiation as well as clinical manifestation.
1. Cassileth BR. Alternative and complementary cancer treatments. Oncologist 1996;1:173–179.
2. Hur J. Dong Eui Bo Gam 1500; etd Cho HY, Kim DI et al.(in Korean). 2003. Yegang Publisher, Seoul, Korea.
3. Pan MJ. Cancer Treatment with Fu Zheng Pei Ben Principle. Translated by Cai Jin-fen, et al. Fuzhou: Fujian Sci Technol Publishing House; 1992:371.
4. Song I B. An Introduction to Sasang Constitutional Medicine. Jimoondang. 2005.