Why Isn’t Traditional Chinese Medicine Commonly Used in the US?
U.S.-based clinical trials have not extensively studied the effects of traditional Chinese herbs in lung cancer care to justify their use yet. Chinese researchers have conducted such clinical trials for decades and believe the evidence supports the use of Chinese herbs in cancer care.
While the use of medicinal herbs continues to be an integral part of Chinese culture and treatment, the average American cancer patient is usually unaware that herbs may have an impact on chemotherapy results.
Many Chinese cancer patients begin taking astragalus — a common medicinal herb in China — before they receive chemotherapy with the hopes of improving survival and lessening side effects.
However, the U.S. National Center for Complementary and Integrative Health reports that no high-quality studies of astragalus use in cancer patients has been conducted in the U.S.
Because mesothelioma is a rare cancer, no clinical trials on Chinese herbs for mesothelioma have been conducted. Certain herbs may be helpful for mesothelioma patients, but there is no scientific evidence on the value of Chinese herbs in mesothelioma, and no studies have investigated the potential risks and side effects.
Mesothelioma patients should discuss any herb or natural remedy with their doctor prior to using it to make sure it is safe.
Chinese Herbs and Lung Cancer Care
Approximately 133 Chinese herbs have been historically used in the treatment of lung cancer. The herbs used most frequently may have healing effects on lung tissue and may boost the immune system.
In 2013, PLoS One published a review of 24 Chinese clinical trials on non-small cell lung cancer.
The most commonly used Chinese herbs include:
- Astragalus: One of the most widely used herbs in Chinese medicine, astragalus root appears to boost the immune system in clinical trials. According to Memorial Sloan-Kettering Cancer Center’s research, astragalus limits tumor growth and spreading, reduces the immune-suppressing effects of chemotherapy, and may enhance the effects of platinum-based chemotherapy drugs like cisplatin and carboplatin. A 2012 study published in Medical Oncology reported improved quality of life among lung cancer patients taking astragalus injection during chemotherapy with cisplatin and vinorelbine.
- Nan Sha Shen: Also known as American silvertop root, research suggests it acts as an antibiotic and may help a dry cough with little phlegm. In 2010, a study published in Immunopharmacology and Immunotoxicology injected the herb into the peritoneum and reported a reduction in inflammation, vascular permeability and cancer-promoting compounds.
- Gan Cao: According to the World Health Organization, gan cao, also known as licorice root, acts as an expectorant that accelerates mucus secretion. Chinese medicine practitioners prescribe the herb to help coughing and shortness of breath.
- Poria: Lung cancer patients experiencing edema (fluid retention beneath the skin) may get some relief from poria, also known as fu ling. The herb has diuretic effects, may reduce production of phlegm and may help insomnia patients sleep better. A 2013 study published in the Journal of Ehtnopharmacology found it effective at relieving edema in rats.
- Oldenlandia Diffusa: Known as snake-needle grass in the U.S., this herb has shown anti-cancer and chemopreventative effects in laboratory and animal studies. In 2011, a mouse study published in Phytotherapy Research also reported anti-inflammatory effects through the reduced production of tumor necrosis factor alpha, interleukin-6 and prostaglandin-2, all of which are commonly overexpressed in mesothelioma cancer.
- Asparagus Root: Though the studies conducted on asparagus root to examine its effects have only been conducted on mice, evidence shows anti-cancer activity against leukemia and lung cancer. And a 1998 mouse study published in the International Journal of Immunopharmacology found that asparagus root limited the production of tumor necrosis factor alpha, which causes inflammation.
- Jin Fu Kang: Another common complementary therapy for lung cancer in China is jin fu kang, a blend of 12 herbal extracts, including astragalus. Developed at the Shanghai University of Traditional Chinese Medicine specifically for the treatment of lung cancer, the formula was clinically tested for decades and was approved by the Chinese drug administration in 1999. Lung cancer patients undergoing chemotherapy who also take jin fu kang often have increased survival rates when compared to chemotherapy treatment alone.
- Yangzheng Xiaoji: Another herbal blend that is used to treat lung cancer is yangzheng xiaoji, a formula of 14 herbs traditionally used to treat cancer in Chinese medicine. A 2013 test tube study published in Anticancer Research found that it may limit the spread of cancer cells and that it works synergistically with chemotherapy. A 2015 study published in the Journal of Translational Medicine found yangzheng xiaoji reduced the spread of lung cancer cells in a laboratory setting.
Benefits, Risks Remain Unknown in US Clinical Trials
Clinical trials on herbal medicine in cancer care are uncommon in the U.S, and this contributes to a lack of scientific consensus in America.
In 2013, BioMed Central Complementary and Alternative Medicine, a British medical journal, published a review of nearly 3,000 Chinese clinical trials on cancer dating back to 1911 and reported that 72% of the studies combined conventional cancer treatment with traditional Chinese medicine.
The most frequently reported benefits of Chinese medicine in these cancer studies included:
- Clinical symptom improvement (56%)
- Biomarker level improvement (42%)
- Quality of life improvement (38%)
- Reduction of treatment side effects (37%)
- Reduced tumor size (29%)
Some of the risks and side effects reported in the study included:
- Allergic reactions
- Herb-drug interactions
- Liver damage
- Genetic damage
- Poisoning from improperly prepared herbs
Until the U.S. invests in clinical trials on the effects of Chinese medicine in cancer care, the scientific consensus will remain unclear. For now, most U.S. doctors refrain from recommending herbs to cancer patients because of a lack of research on proper dosing, drugs interactions and potential side effects.
Working with a Practitioner
The intricacies of Chinese herbal medicine and how specific herbs are prescribed to each individual patient is highly personalized.
The Chinese medicine practitioner considers many individual aspects of each patient before prescribing herbs.
Examples may include:
- A complete medical history of the patient along with a full assessment of their current state of health.
- An examination of your tongue or the outside of your ear. The latter is a part of acupuncture philosophy.
Many details about your health will be collected and considered when deciding which herbs to prescribe. As a result, it isn’t highly recommended for someone to start taking Chinese herbs without consulting an experienced practitioner.
Working with a licensed Chinese medicine practitioner can make the process of obtaining and taking Chinese herbs easier for patients. Experienced practitioners not only know the best sources for Chinese herbs, they can also blend each patient’s unique prescription of various herbs into one capsule to simplify administration.
It’s important for cancer patients to know that most Chinese medicine practitioners are not licensed medical doctors in the U.S. They may be referred to as a traditional Chinese medicine doctor, but unless they went through conventional medical school, training and licensing in the U.S., they are not considered a licensed medical doctor in the United States.
Because most Chinese medicine practitioners do not have a formal medical background, they haven’t received the in-depth training that an oncologist has received to diagnose and treat cancer patients. For this reason, it is important for cancer patients considering herbal medicine to discuss it with their oncologist first.
Your oncologist can warn you of potential drug interactions or unwanted side effects that may come with herbal medicine. Print out any research you found on the herbs you’d like to take and bring them to your oncologist to review.
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