lymphedema resulting from breast cancer surgery

[Guest guest]

Hey all. This is a quick inquiry to see if and how this medicine can

help in the above situation.

 

Female in her late 40s diagnosed with R breast cancer about 4-5 years

ago. Tumor was removed & she went through chemo until signs of cancer

gone. About 4 months ago she went through surgery again because the

cancer had returned but was developing in her R axilla. Again tumor

removed and this time they were not conservative with removing the

lymph nodes. So now she she has moderate/severe lymphedema in the

right arm. The only thing I took a quick look at was her tongue: pale

dusky, no coat, superficial cracks running across the length of the

tongue, sl wet, sl swollen.

 

With the removal of the core lymph nodes to properly drain the arm,

PT w/ good lymphatic massage is definitely the way to go. My question

is: since the structure has been altered so drastically, can one

expect reasonable (i.e. resolution to at least mild/moderate

lymphedema) with gentle warming moxa & internal herbs? Because of the

structural changes, I imagine she would have to be on herbs on/off

for the rest of her life as well as PT+lymphatic massage. I apologize

for having to think in terms of Western medicine, but I did not get

enough info to reach a confident TCM dx. Your ideas are appreciated.

Take care all.

[Guest guest]

Sad to say I've battled a few of those cases tried many CM formulas based on

pattern and nothing touched it -- or will when the lymph glands are removed

it is a mechanical condition and no longer an imbalance. The one tragic case

I worked with was a student. The sweetest middle aged woman and a very

dedicated and loyal student-helper. She was obsessed with lymph edema on her

left leg as a result of previous cancer, radiation and removal of lymph

glands. We tried so many things for months to no avail. She eventually paid

a lot of money to go to a sanatorium in Germany that claimed to specialize

in treating lymph edema. They used a mechanical machine. It was very

extensive and the results were tentative and measured.

 

Eventually I tried to get her to simply accept that that was the way things

were going to be. She kept getting treatments from me with acupuncture and

herbs and nothing happened. The lesson was that she suddenly developed a

very aggressive form of non-small cell lung cancer and went from people

quite healthy with a swollen left leg to dead within four months.

 

That's when I felt inspired to write my book Treating Cancer with herbs.

 

At some point I want to talk with some of you about cancer, get some

feedback and offer a few of my experiences and observations for whatever

they are worth.

 

Anyway, I'm eager to know if anyone out there has had success with this

condition. I've seen two patients that readily come to mind that I've

treated and had no positive response from either.

 

Michael Tierra

 

 

 

_____

 

 

On Behalf Of Mike G

Monday, February 18, 2008 7:51 PM

 

lymphedema resulting from breast cancer surgery

 

 

 

Hey all. This is a quick inquiry to see if and how this medicine can

help in the above situation.

 

Female in her late 40s diagnosed with R breast cancer about 4-5 years

ago. Tumor was removed & she went through chemo until signs of cancer

gone. About 4 months ago she went through surgery again because the

cancer had returned but was developing in her R axilla. Again tumor

removed and this time they were not conservative with removing the

lymph nodes. So now she she has moderate/severe lymphedema in the

right arm. The only thing I took a quick look at was her tongue: pale

dusky, no coat, superficial cracks running across the length of the

tongue, sl wet, sl swollen.

 

With the removal of the core lymph nodes to properly drain the arm,

PT w/ good lymphatic massage is definitely the way to go. My question

is: since the structure has been altered so drastically, can one

expect reasonable (i.e. resolution to at least mild/moderate

lymphedema) with gentle warming moxa & internal herbs? Because of the

structural changes, I imagine she would have to be on herbs on/off

for the rest of her life as well as PT+lymphatic massage. I apologize

for having to think in terms of Western medicine, but I did not get

enough info to reach a confident TCM dx. Your ideas are appreciated.

Take care all.

 

 

 

 

 

_____

 

<< ella for Spam Control >> has removed 5379 Spam messages and set aside

3280 Newsletters for me

You can use it too - and it's FREE! www.ellaforspam.com

 

 

 

[Guest guest]

When I was in China a few years ago studying with breast cancer CM

oncologists, doctors either chose a combination of lou lu, si gua luo and lu lu

tong,

or gui zhi and di long for lymphedema (didn't see many doctors using jiang

huang). In Shanghai, however, lymphedema was common with radical mastectomy and

full lymph node excision the norm. I haven't worked with it as much in the

US, because surgery is so lymph node sparing. In my expeirence, lymphedema can

be pretty well controllable with herbs and MLD.

-Anne

 

 

 

 

Dr. Anne Jeffres, DAOM, LAc

 

Acupuncture & Chinese Herbal Medicine

250 W. 49th St., Suite 503

New York, NY 10019

(212) 542-0459

ajeffres

 

 

 

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(http://living.aol.com/video/how-to-please-your-picky-eater/rachel-campos-duffy/

2050827?NCID=aolcmp00300000002598)

 

 

 

[Guest guest]

Hi Mike, & All,

 

See these, from Medline:

 

1: Acupunct Med. 2005 Dec;23(4):171-80. Comment in: Acupunct Med.

2006 Jun;24(2):92-4; author reply 94-5; discussion 95-6. Acupuncture

and self acupuncture for long-term treatment of vasomotor symptoms in

cancer patients--audit and treatment algorithm. Filshie J, Bolton T,

Browne D, Ashley S. Royal Marsden Hospital, London and Surrey, UK.

jacqueline.filshie INTRODUCTION: Since hormone

replacement therapy given for long periods is now recognised to

produce serious side effects, patients with troublesome vasomotor

symptoms are increasingly using non-hormonal treatment including

acupuncture. Several randomised controlled trials have shown that

acupuncture reduces menopausal symptoms in patients experiencing the

normal climacteric. It may have this effect by raising serotonin

levels which alter the temperature set point in the hypothalamus.

Vasomotor symptoms can be extreme in breast cancer patients and

patients with prostate cancer who are undergoing anticancer therapy.

The safety of some herbal medicines and phytoestrogens has been

questioned, as they could potentially interfere adversely with the

bioavailability of tumouricidal drugs. A previous study reports short

term benefit from acupuncture, and the aim of this report is to

describe our approach to long term treatment. ACUPUNCTURE APPROACH:

After piloting several approaches, six weekly treatments were given

initially at LI4, TE5, LR3 and SP6 and two upper sternal points, but

avoiding any limb with existing lymphoedema or prone to developing

it. If there were no contraindications, patients were given clear

instructions on how to perform self acupuncture using either semi-

permanent needles or conventional needling at SP6, weekly for up to

six years, for long term maintenance. AUDIT METHODS AND RESULTS: A

retrospective audit of electronic records was carried out by a doctor

not involved in treatment. A total of 194 patients were treated,

predominantly with breast and prostate cancer. One hundred and eighty

two patients were female. The number of pre-treatment hot flushes per

day was estimated by the patient: in the 159 cases providing adequate

records, the mean was 16 flushes per day. Following treatment, 114

(79%) gained a 50% or greater reduction in hot flushes and 30 (21%) a

less than 50% reduction. Treatment was abandoned in those who

responded poorly or not at all. The duration of treatment varied from

one month to over six years with a mean duration of nine months.

Seventeen patients (9%) experienced minor side effects over the six

year period, mostly minor rashes; one patient described leg swelling

but this was likely to be due to a concurrent fracture. CONCLUSION:

Acupuncture including self acupuncture is associated with long-term

relief of vasomotor symptoms in cancer patients. Treatment is safe

and costs appear to be low. An algorithm is presented to guide

clinical use. We recommend the use of self acupuncture with needles

at SP6 in preference to semi-permanent needles in the first instance,

but poor responders use indwelling studs if they fail to respond

adequately to self acupuncture with regular needles. Point location

may be of less importance than the overall 'dose', and an appropriate

minimum dose may be required to initiate the effect. PMID: 16430125

[PubMed - indexed for MEDLINE]

 

2: Am J Chin Med. 2002;30(1):37-43. Effectiveness of acupuncture and

moxibustion treatment for lymphedema following intrapelvic lymph node

dissection: a preliminary report. Kanakura Y, Niwa K, Kometani K,

Nakazawa K, Yamaguchi Y, Ishikawa H, Watanabe A, Tokunaga Y.

Department of Gynecology and Obstetrics, Second Teaching School of

Medicine, Fujita Health University, Nagoya, Aichi, Japan. Although it

is difficult in Western medicine to eliminate edema occurring in the

lower extremities after intrapelvic lymph node dissection for

malignant gynecologic tumors, we successfully treated or prevented

this postoperative complication with moxibustion and acupuncture,

initiated after the occurrence of lymphedema in 12 patients and as

soon as possible after surgery in 12 others. An increase in deep body

temperature with acupuncture or moxibustion was found to be essential

for successful treatment. PMID: 12067095 [PubMed - indexed for

MEDLINE]

 

3: Acupunct Med. 2001 Dec;19(2):117-22. Safety aspects of acupuncture

in palliative care. Filshie J. Royal Marsden Hospital London.

jacqueline.filshie Acupuncture can mask symptoms of

cancer and tumour progression. It is not safe to use such a therapy

without full knowledge of the clinical stage of the disease, and the

current status of orthodox therapy. Contraindications to acupuncture

needling include an unstable spine, severe clotting disorder,

neutropenia and lymphoedema. Whilst semi-permanent needles are used

increasingly in symptom control and pain management they should not

be used in patients with valvular heart disease or in vulnerable

neutropenic patients. Acupuncture has an increasing role in support

for pain and symptom management, but patients should not be advised

to abandon conventional treatments in favour of complementary or

alternative therapies alone, and should not have their hopes raised

inappropriately, or have any guilt projected on to them for the cause

of their cancer. PMID: 11829159 [PubMed - indexed for MEDLINE]

 

4: J Clin Oncol. 2000 Feb;18(3):668-83. Research on

complementary/alternative medicine for patients with breast cancer: a

review of the biomedical literature. Jacobson JS, Workman SB,

Kronenberg F. Division of Epidemiology, School of Public Health,

Herbert Irving Comprehensive Cancer Center, Department of

Rehabilitation Medicine, College of Physicians and Surgeons, Columbia

University, New York, NY 10032, USA. jsj4 PURPOSE: This

article reviews English-language articles published in the biomedical

literature from 1980 to 1997 that reported results of clinical

research on complementary and alternative medical treatments (CAM) of

interest to patients with breast cancer. METHODS: We searched 12

electronic databases and the bibliographies of the retrieved papers,

review articles, and books on CAM and breast cancer. The retrieved

articles were grouped by end point: breast cancer (eg, tumor size,

survival), disease-related symptoms, side effects of treatment, and

immune function. Within each end point, we organized the articles by

modality and assessed study design, findings, and qualitative

aspects. RESULTS: Of the more than 1,000 citations retrieved, 51 fit

our criteria for review. Of the articles reviewed, 17 were randomized

clinical trials; three of these were trials of cancer-directed

interventions, two of which involved the same treatment (melatonin).

Seven articles described observational studies, and the remainder

were reports of phase I or II trials. Relatively few CAM modalities

reportedly used by many breast cancer patients were mentioned in

articles retrieved by this process. Most articles had shortcomings.

CONCLUSION: Although many studies had encouraging results, none

showed definitively that a CAM treatment altered disease progression

in patients with breast cancer. Several modalities seemed to improve

other outcomes (eg, acupuncture for nausea, pressure treatments for

lymphedema). If CAM studies are well-founded, well-designed, and

meticulously conducted, and their hypotheses, methods, and results

are reported clearly and candidly, research in this controversial

area should acquire credibility both in the scientific community and

among advocates of unconventional medicine. PMID: 10653883 [PubMed -

indexed for MEDLINE]

 

5: Z Lymphol. 1996 Jun;20(1):43-5. [sequelae of manipulation of the

postmastectomy arm] [Article in German] Klimaschewski H. Seeklinik

Zechlin, Fachklinik für Lymphologie und Odemkrankheiten. PMID:

8768050 [PubMed - indexed for MEDLINE]

 

6: J R Soc Med. 1988 Jun;81(6):341-4. The management of symptoms in

advanced cancer: experience in a hospital-based continuing care unit.

Hoskin PJ, Hanks GW. Continuing Care Unit, Royal Marsden Hospital,

Sutton, Surrey. The treatment received by 158 patients with advanced

cancer admitted over one year to the Continuing Care Unit at the

Royal Marsden Hospital has been reviewed. The unit is an integral

part of the hospital and this is reflected in the fact that 46

patients (29%) received radiotherapy, hormone therapy, chemotherapy

or surgery in addition to symptomatic treatment for palliation of

troublesome symptoms. One hundred and thirty-one patients received

oral morphine in doses ranging from 2.5 mg 4-hourly to 700 mg 4-

hourly. Patients with renal or hepatic impairment required lower

doses of morphine and there was a highly significant inverse

relationship between morphine dose and age. Eighty-five patients

(54%) received parenteral diamorphine at some time due to their

inability to take oral morphine. One hundred and twenty-three

patients (78%) received a co-analgesic drug and anti-emetics were

required by 78 patients (49% overall; 56% of those receiving

morphine). Transcutaneous electrical nerve stimulation, acupuncture

and relaxation were employed in selected patients, and graduated

compression sleeves were used to treat lymphoedema. These data

highlight the wide range of therapeutic options available to control

the symptoms of advanced cancer and also indicate that tumoricidal

treatments used in conjunction with symptomatic treatments may have a

significant part to play. PMCID: PMC1291628 PMID: 2457110 [PubMed -

indexed for MEDLINE]

 

7: Z Lymphol. 1984 Jun;8(1):41-3. [unconventional concepts of

treatment in diseases of the lymphatic system] [Article in German]

Oepen I. PMID: 6485511 [PubMed - indexed for MEDLINE]

 

Best regards,

 

HOME + WORK: 1 Esker Lawns, Lucan, Dublin, Ireland

Tel: (H): +353-(0);

VOIP Number: +353-1482-7068;

Tel: (M): +353-(0)

<

 

 

 

" Man who says it can't be done should not interrupt woman doing it " -

Chinese Proverb

[Guest guest]

Hey, Mike. Not quite sure where to take this. I think if you want to

assure yourself and your patient, I think ,

acupuncture and herbs can help this woman. But I would pick up on the

question and don't " expect " anything, just do your best and trust its

all for the better. Don't set yourself and your patient up with

expectations and/or timetables etc... She's got a lifetime of

situations ahead, ups and perhaps downs, no " hopes " , just be as smart

as you are... you get the idea... tell us what happens.

Doug

 

 

, " Mike G " <m1kegonza wrote:

>

> Hey all. This is a quick inquiry to see if and how this medicine can

> help in the above situation.

>

> Female in her late 40s diagnosed with R breast cancer about 4-5 years

> ago. Tumor was removed & she went through chemo until signs of cancer

> gone. About 4 months ago she went through surgery again because the

> cancer had returned but was developing in her R axilla. Again tumor

> removed and this time they were not conservative with removing the

> lymph nodes. So now she she has moderate/severe lymphedema in the

> right arm. The only thing I took a quick look at was her tongue: pale

> dusky, no coat, superficial cracks running across the length of the

> tongue, sl wet, sl swollen.

>

> With the removal of the core lymph nodes to properly drain the arm,

> PT w/ good lymphatic massage is definitely the way to go. My question

> is: since the structure has been altered so drastically, can one

> expect reasonable (i.e. resolution to at least mild/moderate

> lymphedema) with gentle warming moxa & internal herbs? Because of the

> structural changes, I imagine she would have to be on herbs on/off

> for the rest of her life as well as PT+lymphatic massage. I apologize

> for having to think in terms of Western medicine, but I did not get

> enough info to reach a confident TCM dx. Your ideas are appreciated.

> Take care all.

>

[Guest guest]

If you care to share more, considering the problems I've had with that

condition I would like to know more detail about your approach. I see it as

a mechanical problem, you eliminate the lymph nodes and the body cannot

eliminate the lymph.

 

What did they do in Shanghai?

 

Michael Tierra

 

 

_____

 

 

On Behalf Of ajeffres

Tuesday, February 19, 2008 8:59 PM

 

Re:lymphedema resulting from breast cancer surgery

 

 

 

 

When I was in China a few years ago studying with breast cancer CM

oncologists, doctors either chose a combination of lou lu, si gua luo and lu

lu tong,

or gui zhi and di long for lymphedema (didn't see many doctors using jiang

huang). In Shanghai, however, lymphedema was common with radical mastectomy

and

full lymph node excision the norm. I haven't worked with it as much in the

US, because surgery is so lymph node sparing. In my expeirence, lymphedema

can

be pretty well controllable with herbs and MLD.

-Anne

 

 

 

Dr. Anne Jeffres, DAOM, LAc

 

Acupuncture & Chinese Herbal Medicine

250 W. 49th St., Suite 503

New York, NY 10019

(212) 542-0459

ajeffres (AT) aol (DOT) <ajeffres%40aol.com> com

 

**************Ideas to please picky eaters. Watch video on AOL Living.

(http://living.

<http://living.aol.com/video/how-to-please-your-picky-eater/rachel-campos-du

ffy/> aol.com/video/how-to-please-your-picky-eater/rachel-campos-duffy/

2050827?NCID=aolcmp00300000002598)