Colorectal cancer and Chinese medicine

Updated: Mar 14



(Image source: https://www.ccalliance.org/colorectal-cancer-information/stage-of-diagnosis)


Colorectal cancer is a very common tumor of the digestive tract. In the United States, it is the second most common and fatal cancer among men and women. Based on the ratio from 2007 to 2009, it is predicted that 5.0% of American men and women born today will have colorectal cancer in their lifetime.


Fortunately, if detected early, colorectal cancer is highly treatable and usually curable. Surgery is the main form of treatment, and about 50% of patients can be cured. However, recurrence after surgery is a major problem, usually the ultimate cause of death, and this is also the main direction of traditional Chinese medicine to work on.


A Korea team reported a nanoporous stainless steel acupuncture needle with enhanced therapeutic properties, evaluated by electrophysiological and behavioral responses in Sprague-Dawley (SD) rats. They then investigate molecular changes in colorectal cancer (CRC) rats by acupuncture treatment using the nanoporous needles. Treatment at acupoint HT7 is found most effective at reducing average tumor size, β-catenin expression levels, and the number of aberrant crypt foci in the colon endothelium. They conclude that surface modification of acupuncture needles further enhances the therapeutic effects of acupuncture treatment in CRC rats.


A China team used a formulation of Traditional Chinese medicine, to evaluate the effects of Yi-Yi-Fu-Zi-Bai-Jiang-San (YYFZBJS) on of colon carcinogenesis in vivo and in vitro. They found that YYFZBJS treatment blocked tumor initiation and progression in ApcMin/+ mice with less change of body weight and increased immune function. Moreover, diversity analysis of fecal samples demonstrated that YYFZBJS regulated animal's natural gut flora, including Bacteroides fragilis, Lachnospiraceae and so on. Intestinal tumors from conventional and germ-free mice fed with stool from YYFZBJS volunteers had been decreased. Some inflammation' expression also have been regulated by the gut microbiota mediated immune cells. Intestinal lymphatic, and mesenteric lymph nodes (MLN), accumulated CD4+ CD25+ Foxp3 positive Treg cells were reduced by YYFZBJS treatment in ApcMin/+ mice. Although YYFZBJS had no inhibition on CRC cell proliferation by itself, the altered Tregs mediated by YYFZBJS repressed CRC cancer cell growth, along with reduction of the phosphorylation of β-catenin. They conclude that gut microbiota and Treg were involved in CRC development and progression, and we propose YYFZBJS as a new potential drug option for the treatment of CRC.


Personal experiences:


I follow the principle of focusing on TCM syndrome patterns + disease differentiation + symptomatic therapy. I pay attention to combining modern pharmacological research, and choose drugs with definite anti-tumor effects under the premise of the law of syndrome differentiation and treatment, so as to make the prescription more targeted and improve the clinical efficacy. In a prescription, medicines for syndrome differentiation account for about 50%, medicines for disease differentiation account for about 30%, and medicines for symptomatic treatment account for about 20%. However, this ratio is not static, but can be adjusted flexibly according to the different conditions of patients. Because of the weak anti-cancer and tumor suppression effect of the prescription of TCM syndrome differentiation alone, the long-term anti-tumor effect is still unsatisfactory. Therefore, based on the " disease differentiation (tumor)" model of western medicine, some Chinese medicines with certain anti-cancer effects are. These herbs directly act on the tumor, with a similar mechanism chemotherapeutic drugs, which can inhibit the growth and proliferation of tumor cells. These herbs include Kushen, Baihuasheshecao and Baitouwen.


I also use acupuncture to change microenvironment of tumor. Commonly used points are: Baihui (DU20, Quchi (LI10), Hegu (LI4), Zusanli (ST36), Sanyinjiao (SP6), Taicong (LR3), and Yongquan (KI1).


References:


1. Bo Ram Lee, Hye-Rim Kim, Eun-Sook Choi, Jung-Hoon Cho, Nam-Jun Kim, Jung-Hee Kim, Kyeong-Min Lee, Abdul Razzaq, Hansaem Choi, Yunju Hwang, Craig A. Grimes, Bong-Hyo Lee, Eunjoo Kim, and Su-Il. Enhanced Therapeutic Treatment of Colorectal Cancer Using Surface-Modified Nanoporous Acupuncture Needles. Sci Rep. 2017; 7: 12900.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5635022/

2. Hua Sui , Lu Zhang , Kaijuan Gu , Ni Chai , Qing Ji , Lihong Zhou , Yan Wang , Junze Ren , Limei Yang , Bimeng Zhang , Jing Hu , Qi Li. YYFZBJS ameliorates colorectal cancer progression in Apc Min/+ mice by remodeling gut microbiota and inhibiting regulatory T-cell generation Cell Commun Signal. 2020;18(1):113.

https://pubmed.ncbi.nlm.nih.gov/32677955/


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