Cancer- An Ayurvedic Approach and Treatment Guidelines

Synonyms:
Cancer, Tumour, Arbuda (Ayurvedic terminology)

Arbuda means-
According to ‘Sushruta’ (School of Ayurvedic Surgery), aggravated Vata, Pitta and Kapha- Doshas when vitiate the ‘Mamsa’ (muscle fibres) and other body elements and lead to development of a rounded, fixed, large, deep rooted, slow growing, non-inflammatory swelling associated with mild pain. Such swelling is termed ‘Arbuda’.

Cancer means-
Cancer is defined as ‘a mass of tissue formed as result of abnormal, excessive, uncoordinated, autonomous and purposeless proliferation of cells’. It is also termed as ‘malignant neoplasm’. These neoplasm spread very fast throughout the body and may finally leads to the general condition worse. On the other hand benign neoplasm grow slowly, are encapsulated, move freely, hardly infiltrate the surrounding tissues and never metastasize either to the regional lymph nodes or to the distant organs without causing much discomfort to the patient.
The study of neoplasm is termed ‘Oncology’.

Nomenclature-
Tumour is named mainly on their parenchyma components (‘Parenchyma’ is composed mainly of proliferating tumour cells).
Suffix- ‘oma’ is added to denote benign tumour.
Suffix- ‘sarcoma’ is added to denote malignant tumour.
Staging of Cancer:
Generally TNM System is followed.
T– Primary Tumour size.
N– Lymph Nodes involvement.
M– Distant Metastasis.
Metastasis (Distant Spread)-
Benign tumours do not metastasis whereas all malignant tumours (with few exceptions) get metastasis. Generally larger and more rapidly growing tumours show greater tendency to metastasis. Malignant tumours get metastasis through lymphatic channels or through blood.
Classification of Cancer/Tumour:

Classification of Arbuda:
‘Arbuda’ is classified in to six types according to the vitiated dosha and tissue involvement.
1) Vataja arbuda: The swelling is associated with throbbing pain etc, black in colour, consistency is hard, appears like a distended bladder, when pricked clear blood exudes out.
2) Pittaja arbuda: The swelling is associated with burning pain, sucking pain etc., red with slightly yellowish tints, when pricked exudes large quantity of warm blood.
3) Kaphaja arbuda: The swelling is cold on touch, not discoloured, associated with mild pain and severe itching, attains bigger size, develops slowly, when pricked exudes whitish, thick pus.
4) Raktaja arbuda (Raktarbuda/ Blood Cancer): The vitiated blood develops a rapidly growing swelling, covered with fleshy sprouts which readily bleed on touch. This condition is incurable while Ayurvedic treatment is concern.
5) Mansaja arbuda (Mansarbuda): The tissue at the area of trauma, gets vitiated, leading to the formation of a painless, hard (stony hard or bony hard consistency), fixed swelling having a colour similar to the surrounding skin. This condition incurable by Ayurvedic treatment and it is manifest generally in those people who consume meat constantly and excessively.
6) Medaja arbuda: The swelling is huge in size, associated with mild pain and severe itching, when pricked exudes discharge similar of ghee (clarified butter) or paste of sesame seeds, the size of the swelling varies with variation in the size of body.
Adhyarbuda– Tumour growing over previously manifested one is termed ‘Adhyarbuda’.
Dviraarbuda– Tumours which manifest either simultaneously or sometimes after the manifestation of primary tumours is defined as ‘Dviraarbuda’ (Secondary tumour).

Characteristic features of tumours-

Malignant tumours (in comparison to benign tumors) produce local as well as generalised symptoms in the patient.

1) Local effects
Compression effect- Tumours because of their critical position (and many times owing to their size) may produce varied compressive features.
For example-
Tumours at ampulla of vater may lead to billiary obstruction.
Tumours of head of pancreas may lead to biliary stasis.
Tumours may easily undergo ulceration, haemorrhage, have superadded bacterial infections or may undergo torsion (e.g. ovarian tumour etc.)

2) Cachexia-
In advanced stages of cancer, patients present with anorexia and wasting which may be secondary to increased nutritional demands of the tumour or due to haemorrhage, secondary infection, mal absorption, anxiety etc.

3) Fever-
Fever of unknown origin can be a presenting feature in certain malignancies viz. Hodgkin’s disease, Osteogenic sarcoma etc.
Important Note- It may so happen that a tumour may be benign to start with, but may undergo malignant transformation at some stage. The malignant transformation is recognized by-
1)      Sudden increase in the size of swelling.
2)      Increase in vascularity of the tumour with rise of local temperature.
3)      Fixity of the tumour infiltration of the surrounding tissues.
4)      Secondary changes in the tumour either in the form of increase pigmentation.
5)      Appearance of pain, which is a late feature of malignant disease.
6)      Involvement of regional nodes.
7)      Appearance of distant metastasis.

Ayurvedic Treatment for Cancer:

• The management of cancer is possible only by a multi-specialty team of doctors. However surgery remains the definitive treatment and the only chance of cure for most of the solid tumours.
• Body purification and rejuvenation by Ayurvedic Panchkarma Therapy (includes Vamana Procedure(Medical Emesis), Virechana Procedure (Purgation), Basti Procedures (Medicated Enema)- Anuvasana & Asthapana basti, Siravyadha Chikitsa (Bloodletting)) play a great role for the treatment of cancer through Ayurveda.
• As per ‘Sushruta’ (School of Ayurvedic Surgery), the cancer tumours should be radically excised. Radical surgery for cure of malignancy, involves removal of the primary tumour, along with a rim of surrounding healthy tissue and the regional lymph nodes. This cures the primary lesion and reduces the chances of metastasis through lymphatic channels.
• Reconstructive surgery: After excision of the primary lesion and secondary metastatic deposits, ensures return of normal physiology or improves the cosmetic appeal of the region.
• Radiotherapy: Radiotherapy in the form of X-ray or gamma rays has certain advantages viz. 1) Deep seated tumours can be treated. 2) Absorption of radiation is similar in all tissues.
  Complications of radiotherapy: Radiotherapy is associated with a certain disadvantages viz. inevitable damage to surrounding tissue. The most sensitive tissues are bone marrow, gonads, eye, mucosa of gastro-intestinal tract, skin, lung tissue, kidney, liver, bone etc.
• Chemotherapy: Advent of newer drugs has widening the scope of chemotherapy. Chemotherapy is most successful in the treatment of haematological malignancies like lymphoma, leukaemia etc. Ovarian cancer, breast cancer, prostate cancer, testicular cancer etc. also respond well to chemotherapy.
  Oesophageal cancer, pancreatic cancer and squamous cell carcinoma of lungs are marginally responsive or unresponsive to chemotherapy.
  Chemotherapy rather than being used alone, when used as adjuvant therapy along with surgery etc. has better success rates.
  Complications of Chemotherapy: Toxicity is the main limiting factor for chemotherapy. Nausea, vomiting, alopecia, leucopoenia, thrombocytopenia, infertility etc. are some of the common complications of chemotherapy.

• Ayurvedic treatment for  Arbuda (Cancer/ Tumor):
  Ayurvedic treatment for Vataja Arbuda:
  External application: External oil massage by Coconut oil and Castor oil, hot fomentation by ‘Naadi Sweda’, poultice application by cooked meat, bloodletting locally by ‘Shring Yantra’.
  Oral medication: Trivrit grita (Clarified butter prepared with ‘Trivrit’), Mahanarayana taila (Mahanarayana oil), Kshirbala taila (Kshirbala oil).
  Panchkarma treatment:  Basti Chikitsa (Enema treatment by medicated oils).
  Para surgical treatment: Siravyadha Chikitsa (Bloodletting).
  Ayurvedic treatment for Pittaja Arbuda:
  External application: Poultice application by cooked meat, light hot fomentation and paste application (lepa application): Do scrapping by the leaves of ‘Udumbara’ tree and then apply powder of ‘Yastimadhu’ mix with honey.
  Oral medication: Trivrit grita (Clarified butter prepared with ‘Trivrit’), Mahatiktaka grita, Yashtimadhu grita, Panchtikta grita.
  Panchkarma treatment:  Virechana Chikitsa (Purgation).
  Para surgical treatment: Siravyadha Chikitsa (Bloodletting) locally.
  Ayurvedic treatment for Kaphaja Arbuda:
  Do body purification by Ayurvedic Panchkarma Therapy treatment first and then do bloodletting locally.
  External application: After bloodletting one should apply paste of ayurvedic herbs like ‘Triphala’.
  Oral medication: Mahatiktaka grita, Bhallataka taila (Bhallataka oil)
  Panchkarma treatment:  Basti Chikitsa (Enema treatment by medicated oils).
  Surgical treatment: Do radical excision of tumour if possible.
  Para surgical treatment: Siravyadha Chikitsa (Bloodletting).
  Ayurvedic treatment for Medaja Arbuda:
  Do hot fomentation first and then excised the tumour completely when it become clear and complete haemostasis achieved, suture the wound.
  External application: Karanjadi taila (Karanjadi oil).
  Oral medication: Triphala Kwath, Kanchnar guggulu tablet, Gomutra Haritaki tablet, Navak guggulu tablet, Triphala guggulu tablet, Vidangarishta, Ayaskriti (a type of medicated wine)
  Ayurvedic treatment for Raktaja & Mansaja Arbuda: These both conditions are incurable by Ayurvedic treatments.