Metastasis of Nasopharyngeal Cancer

Patient Details

Name: Liem XX | Age: 69 | Race: Chinese | Sex: Female |

History

In 2010 the patient was diagnosed as suffering from nasopharyngeal cancer. Seven weeks of chemo- and radio-therapy were given. Her condition stabilised and she recovered.

Symptoms

Two months ago the patient suffered from a sudden weight loss from 49 kg to 45 kg, and complained of double vision and involuntary facial twitches. She was diagnosed and confirmed as metastasis of her previous cancer.

Oral Capecitabine was prescribed for two weeks with one week rest to be followed by another stronger dosage of Capecitabine and so on.

Chinese medicine was suggested to complement her chemotherapy.

Diagnosis

Apart from the double vision and facial twitches, she has thirst at night with desire for drinks and early waking. Her appetite was normal, her tongue was deep red with scant coating and her pulse was wiry with weak Chi pulse.

Treatment

There was no excessive side effects during her current chemotherapy compaired to her initial chemotherapy in 2010 when she experienced severe vomiting and diarrhoea. In contrast to her reaction in 2010 she did not complain of any notable side effects whilst taking Chinese herbal medicine to supplement her chemo-therapy treatment.

Prescription

Bie Jia 15g; Xian He Cao 15g; Chai Hu 10g; Fang Feng 12g; Chuan Xiong 10g; Cang Er Zhi 10g; Sheng Zhi Huang Qi 15g each; Chuan Shan Long 15g; Fo Shou 6g; Zhu Ru 10g; Xuan Shen 10g; Mu Li 15g; Xia Ku Cao 10g; Quan Xie 6g; Jiang Can 10g; Yin Hua 15g; Chao Zao Ren 10g; Yuan Zhi 10g; He Huan Pi 15g; Bai Ji Li 15g; Xu Chang Qing 10g; Mai Dong 10g; Jie Geng 10g; Hu Zhang 10g; Sheng Gan Cao 10g.

Discussion

Nasopharyngeal cancer is a prevalent cancer in China with the primary site in the nasopharynx but can affect inside the cranium with metastasis to the lymph nodes or bone, liver and lung via blood circulation. Some of the frequently encountered symptoms are nasal blockage, blood-streaked nasal discharge, tinnitus, headache and damage to the cranial nerve. The nose is the orifice of the lung while the pharynx is the gateway to the lung and stomach. The key pathogenesis of nasopharyngeal cancer is yin deficiency as the root with phlegm and stasis heat as the tip. Treatment strategy is to augment qi, nourish yin, soften the mass and dissipate swelling. Bie Jia enters the liver channel, invigorates blood, transforms stasis and disperses the knotted bind; Xia Ku Cao disperses constrained liver, clears heat, dissipates bind and reduces swelling. Chuan Xiong is acrid and warm and is the qi herb to free and regulate qi and blood; Chuan Shan Long invigorates blood and unblocks collaterals; Jiang Can disperses knotted bind; and Xu Chang Qin invigorates blood. The blood invigorating function is substantially enhanced by the addition of wind herbs such as Bai Ji Li. The overall objective is to nourish yin, augment qi, disperse knotted bind and invigorate blood.

Follow Up

After several courses of Chemotherapy, the cancer is fully under control and the oncologist suggests to continue with the chemo as she has been doing so well. The patient recounted that she was able to carry normal daily life with no undue discomfort. The oncologist was amazed that she is keeping so well as in December 2016, the doctor remarked that if the chemo failed to work, her life expectancy would be six months only. This is a classic example of how Chinese medicine can work in conjunction with chemotherapy. Well done, Professor Li Zhong!!

Follow-up Report (12th August 2017):

Further report on the above case, this patient commenced taking Chinese medicine since mid-December 2016 together with a light dose of chemotherapy with two weeks on and one week off and her condition is stable.

Recently she suffered from facial spasm and double vision. However subsequent MRI confirmed that the tumour had not metastasized   instead it was compressing on her facial nerve.

Professor Li Zhong recent prescription (7th August 2017) :

Zhi Bie Jia 15; Chai Hu 15; Fang Feng 12; Wu Mei 15; Quan Xie 6; Gou Teng 15;Chuan Xiong 10; Cang Er Zi 6; Bai Zhi 10; Sheng Zhi Huang Qi 15 each; Di Long 10; Wei Ling Xian 10; Mu Zei Cao 10; Wu Wei Zi 10; Ren Dong Teng 15; Xu Chang Qing 10; Tao Ren 10; Hong Hua 10; Chuan Shan Long 10; Wu Gong 3; Zhi Shou Wu 10; Bai Ji Li 10; Fo Shou 6; Zhu Ru 10; Zhe Bei Mu 10; Mu Li 30; Bai Shao 30; Jing Jie 6; Shan Shen 10; Zhi Huang Jin 10; Sheng Gan Cao 10. 14 packs.

Chemotherapy : Gemcitabine/carboplatin.

Discussion: Professor Li Zhong incorporated quite a few wind herbs including Wu Gong as Chinese Medicine regards cramps and twitching as wind; there are some astringent herbs in the formula as this can secure the zheng qi with simultaneous prevention of metastasis.  Cang Er Zi and Bai Zhi were included for her nasal blockage; Zhe Bei Mu and Mu Li soften the lump and dissipate the knotted bind while Bie Jia and Huang Jin nourish yin.

On the whole the patient is energetic and her appetite is good.

The patient had her first intravenous Chemo on Thursday (10th August 2017) and her initial reaction was good with no adverse side effects and her energy was also very good. Professor Li Zhong explained that simultaneous Chinese medicine can reduce the side effects of Chemotherapy which in turn increase the outcome effect of chemotherapy.  This is very encouraging, please stay tune for more reports on this patient.


About Professor Li Zhong

Professor Li Zhong 李忠 is a renowned TCM oncologist in the Oncology Department of the Beijing Dongzhimen Hospital. He is currently the Vice Chairman of the Executive Committee of the Professional Committee of China Gerontological Society of Tumour in Be… Read more »


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