Philip A.M. Rogers MRCVS

AP and Immunity CANCER

Chen_HL; Huang XM (1991) Treatment of chemotherapy - induced leucocytopenia with AP and moxibustion. Chung Hsi i Chieh Ho Tsa Chih - Chin J of Modern Developments in Trad Med Jun 11(6):350-352, 325. The effects of AP and moxibustion on WBC counts in 376 cases of chemotherapy-induced leucocytopenia was observed in patients with malignant tumours in the intermediary and advanced stages. In a group treated with AP and moxibustion with warming needle, a positive result (effective + partial) occurred in 88% of cases; in a group treated with moxibustion with ignited moxa cone, some effect occurred in 91% of cases. The difference in effect between the treatments was not significant (p>.05). Total effective rate was 38.2% when compared with the control group on batyl-alcohol and pentoxyl; the difference was significant (p <.01). Regardless of the kind of disease, the chemotherapy regime, and the treatment course used, the effect of AP and moxibustion in raising WBC values depended on the extent of bone marrow inhibition. The effect was better in patients who had higher basic WBC values; the effect was less in those who had lower basic WBC values.

Filshie_J; Redman D (1986) AP and Cancer Research: AP for Malignant Pain Problems. International Med AP Conference, London, UK. May 4-8. Dept. of Anaesthetics, Royal Marsden Hospital, London, UK. The effect of AP was assessed in 183 patients attending the Pain Clinic in a cancer hospital. Early results were promising; 82% of patients got benefit for hours/ds. However, only 52% of patients obtained significant help and multiple treatments were often necessary. AP was most helpful for vascular problems, muscle spasm and dysesthetic problems. AP was significantly helpful for some patients with malignant pain problems.

Halevi_S1 (1996) Can Cancer be Defeated by AP?. Adapted from WWW. Originally published in the CMJ (UK). [Dr Shmuel Halevi is a practitioner of TCM, practising in Israel: WebMaster]. Cancer patients are occasionally seen in the AP clinic, and some of them respond favourably either to AP or herbal treatment. Most cases however, only resort to AP at a late stage in their disease, and usually in despair. Most patients are >50, and, as can be expected, in very bad shape. Partly because of this, cancer patients who benefit from treatment usually experience only symptomatic relief, which, though very significant in some cases, is usually not a complete cure. The following case history concerns a young man, who had come to my clinic only 2 mo after the inception of the disease, and 10 d after diagnosis. Because the disease was in the early stage, and he had not received any chemotherapy or similar treatment, his chances of recovery were significantly higher than those of the average cancer patient.

The patient, Mr E, a 25 yr old army captain, came to my clinic in February 1991. 2 mo before that, after a heavy blow to his face from a basketball, he had started to experience double vision and other visual disturbances. He then gradually lost sensation in his right arm, hand and leg, with marked motor disability of his right hand, and developed dizziness. In the first wk of Feb, Mr E had several bouts of electric-shock-like sensations throughout his entire body, after which he felt completely depleted, and his right side became virtually paralysed. His left eye became fixed in the centre of the orbit, was unable to move at all to the left, and he was only able to see blurred and double shapes. During these 2 mo Mr E had series of urgent Med tests, including an MRI scan of the brain. Radiologists at the Wadassa hospital in Jerusalem and the Assuta hospital in Tel Aviv confirmed the existence of a brain tumour in the medulla pons area, slightly pushing onto the bottom of the 4th cerebral ventricle. He was diagnosed as a brain cancer patient with a rather poor prognosis. Due to the anatomic location of the tumour, surgical procedures were not recommended, nor was any other treatment proposed.

The 3 professors who saw him did not suggest any link between the tumour and the trauma he had suffered earlier.

Clinical manifestations.
Appearance: The patient looked very emaciated, thin and fragile. His right side was obviously feeble and his left eye was fixed in an unblinking, unmoving gaze. He was rather pale and frightened.

The pulse was deep, weak and slow. The middle left (LV) position was thin and very wiry.

The tongue was very swollen, and slightly contracted. He was unable to stick it out at my request. Around the tip there were red points, and the rear portion was covered with dry, thick, yellowish moss.

Palpation: LV was apparently enlarged (circa 1 finger below the ribs), hard and sensitive. LV13 on the left was very tender, as well as points CV14, CV12 and GB20.

Diagnosis: A swollen tongue that was contracted and could not be extended along with a wiry LV pulse, suggested immediately a severe Xue Stasis type of disorder. Both pulse and tongue, along with clear Xue-Stasis symptoms (the tumour, fixed eye etc.), were in agreement with the Western diagnosis of cancer. The slow pulse, along with the obvious emaciation and slight paralysis, suggested an underlying Xu Syndrome of Xue and Qi. His history confirmed a congenital HT problem with a murmur, and bradycardia.

It is my experience that tongue diagnosis of cancer patients is of supreme importance. A swollen, and contracted tongue shows severe damage to the general flow of Xue and Qi. Later, in more advanced stages, it is apt to change into a thin and contracted tongue, and then criss-cross cracks and/or pronounced tooth-marks appear (if they had not existed before). This is a gradual change from a Shi Syndrome into a Xu Syndrome, which reflects the matter-consuming nature of this disease. The patient was therefore still in the Shi stage, although quite quickly deteriorating. I was worried about the impact of this Stasis on his LV. At that time I was afraid of a LV origin to this tumour, in which case the prognosis would have been poorer. Yet he did not have any gastrointestinal complications which LV cancer usually causes, which was a positive sign.

In disagreement with his Western doctors, it was my opinion that the cause of his disease was clearly his basketball accident. The heavy blow to the face tilted his head forcefully backward, causing a sudden and fierce impediment to the flow of Qi-Xue in the occipital region. His underlying Syndrome of Xue Xu due to his congenital HT problem ("HT controls the Xue"), did not allow the trauma focus to recover, and regain its normal free-flow of Qi-Xue. A sudden and heavy pressure of this kind usually generates Heat-Stasis within the skull, which could not expand outwards, thus creating a marked area of Xue-Stasis, possibly culminating in cancer. Also, the pressure of the tumour probably affected the nerves of his left eye, and the Qi-Xue-Stasis in his brain caused his hemiplegic symptoms.

Treatment plan
Being reluctant to act initially directly on the tumour, I aimed first to activate the Qi-Xue in the patient's right limbs. This, plus tonifying his substantial Qi, were intended to assist him in regaining his vital Qi, and to loosen the Stasis focus through the invigoration of the affected regions (e.g. right limbs and left eye). This is similar to treatment procedures used in CVA sequelae.

If this proved successful, the second step would be to act directly on the tumour, using decisive Xue invigoration techniques. This procedure would be carried out, however, only after the patient had regained enough Qi, to enable him to withstand such harsh techniques.

Treatment: Right side: LI04, LI11 and LI15 all with strong, even manipulation. Left side: Qiuhou (Extra) and Z 09 both with even method. Bilaterally: ST36 (strongly reinforced); LV03 (dispersed); SP06 (dispersed); CV04 and CV06 (reinforced). LI04, LI11 and LI15 belong to the hand Yangming Channel which is abundant in Qi-Xue. They are used in TCM as the most potent combination to invigorate the Qi-Xue of the arm and hand. ST36 (also belonging to the Yangming Channel) is probably the most powerful point on the lower limb; it tonifies the circulation in the right leg, and is used as a general tonic also. The combination of ST36 with CV04 and CV06 is renowned for its general tonifying abilities. LV03 and SP06 is also a well known combination, used to tonify LV-Qi, and move Xue. Qiuhou (Extra) and Z 09 were chosen to tonify eye circulation, enhance nervous functioning, and affect the tumour by acting upon its sequelae. Thus, tonifying Qi-Xue in the hand, leg and eye, was supported by a general tonification of LV-Qi and general Qi.

This treatment was given for circa 20 d, sometimes replacing points with others of a similar nature (substituting LI11 for instance, with LI10).

Halevi_S2 (1996) Can Cancer be Defeated by AP?. Originally published in the CMJ (UK).
During these 20 d the patient's condition improved dramatically. His right hand gradually regained its strength, until he was able to write almost as before. His right leg improved even faster and his gait changed to normal after 10 d. The problem in his left eye still remained, even though he was now able to move his eye a little to the left. Though his general energy clearly improved, he still became weak now and then. After 20 d we began the second phase of treatment, and for this 2 sets of points were chosen: Group A: GV20, GV26, GB20, GV16, GV14, LI04 and SI03 (alternated); BL40, BL60 and BL62 (Alternated). Group B: BL43, GV14, BL17 and LI04. Group A was intended to invigorate Qi-Xue in the brain, by acting mainly on the GV Channel. For this purpose points GV20, GV26, GB20 and GV14 were selected near the disease focus. SI03 and BL62 were needled occasionally to open the GV Channel, being the master and coupled points of this Channel. The GV Channel enters the brain and binds all the Yang Channels. Drastic stimulation of the Yang was necessary so as to invigorate the Qi in the brain and eventually dissolve the Xue-Stasis. LI04 and BL60 were chosen for their ability to invigorate Qi-Xue in the head. BL40 and BL60 together have a dramatic impact upon the BL Channel, which also travels through the brain, and eventually terminates in the eye. All these points were manipulated by dispersing method, causing an upward sensation propagating to the head. BL60 was needled with a 4 inch needle, which after the arrival of Qi was directed upwards, causing a distinct sensation through the back to the occiput, and sometimes even to the eyes. After the withdrawal of the needles (and only on days when the patient felt strong enough), olive oil was spread on the back, cups were placed over GV14 and over BL11, and slid up and down the GV and BL Channels several times until the skin reddened. Group B points were used every other day with reinforcing technique. BL43, GV14 and BL17 were also cauterized with moxa on ginger several times, after which the patient would feel very strong for the next few days.

At the end of another mo of almost daily treatments, the patient's left eye could move a fraction farther to the left, his general physical ability became almost normal, his pulse was dramatically regenerated (though still slow), and above all, his tongue could stick out freely, was no longer contracted, was much less swollen, and had lost its thick yellowish fur.

Then the patient received another MRI test in Assuta hospital in Tel Aviv after which it was concluded that "in comparison to the previous inspection there is a reduction in the brain stem expansion. " As a result, Mr E was advised to have radiation therapy. I agreed to this, as he would be receiving AP treatment in parallel with the radiation. Also, the patient received powdered Dang Gui Ji Xue Tang (Tangkuei and Jixuetang Decoction), which is indicated for blood problems (such as leucopenia) which may occur due to radiation therapy.

Apart from a negligible weakness now and then, Mr E withstood radiotherapy in a way that amazed his doctors. However there was no distinguishable change in his condition after the radiation, and I kept treating him as before. Sessions were now given 3 times/wk and directed mainly to his eye problem, with the addition of points either from group A or B, according to his condition. On days when he felt weak, points and techniques of tonification were chosen. On other days group B points and points to affect his eye were utilised. In treating the patient's left eye during this phase, I usually needled points BL01, ST01, Qiuhou (Extra) and Z 09 alternately. All points were punctured deeply (1-2 cun), causing radiating sensations behind the eye ball. Considering that the eye problem was the only symptom he now suffered from, it was hoped that putting full impetus on the eye treatment, along with occasional group A points, would eventually resolve the problem. In 1 yr, during which the frequency of treatment sessions markedly decreased, the patient's eye very slowly improved, until it gained its full orbital movement. Mr E has now resumed his previous job in the army, and comes for AP, in very good health, once/mo.

1. To treat cancer it is very important to assess the patient's condition at the time of each needling session and adjust the approach to treatment accordingly. Cancer patients have notable changes in their Qi (energy level), and the treatment has to be tailored to the state of the patient on the day of the treatment, otherwise deterioration may occur. However, despite this principle, for best results, the treatment plan must address the patient's overall condition and needs. I would call the general treatment plan, which may be composed of several phases, a strategy. By contrast the treatment routine, given daily within the strategy frame, may be called the treatment tactics. The tactics are based on evaluation of the cancer patient's condition before every treatment, and dictate the nature of the treatment for that day. This may include the strength of needle stimulation, the technique (whether needling, cupping, moxa) etc. Confusion between the strategy of the treatment, and its tactics, may cause either a worsening of the condition (which in a cancer patient could be fatal), or a disoriented treatment which can not induce a cure.

2. Many established principles of AP treatment have applications in cancer therapy. Life is at stake and the battle is fierce. When a defined TCM Syndrome is diagnosed, the usual principle is to counteract it: in cases of Heat, Cooling actions are taken, in cases of Shi (Excess), dispersing techniques etc. A cancer-tumour usually involves a Xue-Stasis Syndrome, a situation which calls for techniques to tonify Xue as the main principle of treatment. However, despite the obvious Shi Syndrome, and the basic Xue-Stasis Syndrome, the patient initially received treatments aimed at tonifying the paralysed limbs, and Xue and Qi in general. Only after the Qi was moving normally in his limbs, and his general Qi-Xue level had been raised, as evidenced by his pulse and symptoms, was the Xue-Stasis Syndrome dealt with directly.

Li_QS; Cao SH; Xie GM; Gan YH; Ma HJ; Lu JZ; Zhang ZH (1994) Combined TCM and WM: Relieving effects of Chinese herbs, Ear-AP and epidural morphine on postoperative pain in liver cancer. CMJ (UK) Apr 107(4):289-294. Research Ctr on Pain, Zhong Shan Hospital, Shanghai Med Univ, PRC. 16 male patients with primary liver cancer were observed to evaluate the postoperative relief of pain and abdominal distension induced by Chinese herbs (A), Ear-AP (B) and epidural morphine (C). This study was conducted by means of orthogonal double blind, randomized design. The patients received various treatments according to the display of the orthogonal table L16(2)15 which corresponds to 2 X 2 X 2 factorial design. C+ (morphine 2 mg) was given before the peritoneum was sutured. A+ (orally administered) and B+ were given 24 h after operation. 50-100 mg of pethidine was given when the pain intensity VAS (0-100) exceeded 50-70. The observation parameters included plasma Leu-Enk, postoperative total dosage of narcotics administered for 5 d, VAS for pain and pain reliever, abdominal distension, urinary retention, constipation, etc. Patients who had received A (A+B+C+, A+B+C-, A+B-C-, A+B-C+); C (C+A+B+, C+A+B-, C+A-B+, C+A-B-), or B (B+A+C+, B+A+C-, B+A-C+, B+A-C-) produced better analgesic effects than those who had received placebo. The A, B, and C reduced narcotics 650, 450 and 550 mg respectively when compared with placebo. The effects of A and C were statistically significant (p <.05), while AB, BC, and AC interactions were not found. A and B minimized abdominal distension and urinary retention, while C prolonged them. As compared with the placebo, A and B accelerated restoration of bowel peristalsis (p <.05, ANOVA). Both A and B decreased it for 165 h, while epidural morphine prolonged it for 49 h. (ABSTRACT TRUNCATED AT 250 WORDS).

Sato_A1 (1991) Cancer Chemotherapy with Oriental Med: 2: Clinical Experiments of Oriental Med with Anti-tumour Crude Drugs. International J of Oriental Med 1:34-43. TCM herbs combat the symptoms of chemotherapy and prolong life. They reduce the adverse effects of cytotoxic chemotherapy and radiation therapy:
a. by increasing leucocyte-, erythrocyte- and thrombocyte- counts;
b. by improving digestive functions (especially LV function);
c. by improving KI function;
d. by reducing pain;
e. by enhancing immunofunctions, and especially,
e. by decreasing pain in the terminal stage.

Song_LC; Liu CY; Zhang BP; Wang T; Song YQ; Li YW (1994) Electrochemical therapy (ECT) for thyroid adenoma during APA: analysis of 46 patients. Eur J Surg Suppl 574:79-81. Central District Hospital, Zaozhung, Shandong, PRC. From Feb '89 - Apr '93, 46 patients with thyroid adenoma were treated by electrochemical treatment (ECT) during APA. After a follow up period of 3 mo - 4 yr, the cure rate was 98%. ECT is a new technique which provides simple, effective and safe treatment of thyroid adenoma. Treatment of benign tumours with ECT represents a new application.

Wang_Guan-ting; Xu Jia-yu; Zhang Ai-mei; Wu Xian-yi (1992) Treatment of Postoperative Advanced Gastric Cancer With Chemotherapy and Anticancer Herbs. International J of Oriental Med 4:202-205. Treatment of advanced gastric (ST) cancer with combined chemotherapy and anticancer herbs which "support the righteous Qi" (often translated to Immune System in WM) gave 41 and 30% survival rates at 3 and 5 yr respectively. The survival rates were significantly higher than for those patients receiving chemotherapy only (26 and 15% respectively).

Wu_B1; Zhou RX; Zhou MS (1994) Effect of AP on interleukin-2 level and NK cell immunoactivity of peripheral blood of malignant tumour patients. Chung Kuo Chung Hsi I Chieh Ho Tsa Chih Sep 14(9):537-539. First Affiliated Hospital, Huaxi Med Univ, Chengdu, PRC. This paper deals with the observation of AP therapy affecting interleukin-2 (IL-2) level and natural killer (NK) cell immunoactivity in the peripheral blood of patients with malignant tumours. In this clinical-Lab test research, randomized double blind method was used. The patients were assigned to 2 groups: 1=AP treatment (n=25) and; 2=Control (untreated, n=20). AP was given for 30 min, once/d for 10 d at ST36, LI11, SP06 and symptomatic points bilaterally. IL-2 level and NK cell activity were lower than normal in patients with malignant tumour, but there was a significant (p <.01) increase in the AP group after 10 d of treatment. This increase may be due to the immunoregulatory mechanism of AP. AP therapy enhanced cellular immune function of patients with malignant tumours and helped in anti-cancer treatment.

Wu_B2 (1996) Effect of AP on Immunomodulation in Patients with Malignant Tumours. Wu Bin, First Affiliated Hospital, West China Univ of Med Sci, Chengdu 610041, PRC. Adapted from WWW at (Chin Med News, Beijing Cons Bio-Tech (e-mail: A double blind trial of 40 patients with malignant tumour was designed to study the regulatory role of AP on cellular immune function. Patients were assigned at random to two groups: 1=AP (n=20) and; 2=Control (untreated, n=20). Changes of T-cell subsets (CD3+, CD4+, CD8+), soluble IL-2 receptor (SIL-2R) and beta-End in the blood were studied before and after AP. AP enhanced cellular immunity of patients with malignant tumour; it raised the % T-cell subsets CD3+, CD4+, and the CD4+/CD8+ ratio (p<.01) and the level of beta-End; it decreased the level of SIL-2R (p<.01). Beta-End and T lymphocyte subsets correlated positively; beta-End and SIL-2R correlated negatively and T-cell subsets and SIL-2R correlated negatively. The paper discussed the effects of AP on immunomodulation and the possible mechanisms involved in those effects.

Xia_YQ2 et al (1986) Immunity Reflex State in Cancer patients Treated by AP. Chin AP & Moxibustion Apr 6(2):17-19. (In Chinese). 59 cases with cancer (diagnosed through tissue biopsy) were observed; cellular immunity was lower than in normal persons. Radiation treatment had inhibitory functions on body immunity. AP raised body immunity and regulated ERFC close to the normal level; it also controlled the immunosuppression caused by radiation treatments.

Yang_J3; Yu M; Zhao R; Chen G; Li L; Cai L; Zhang Z; Zhang Y; Lu W (1995) [Influence of radiotherapy and chemotherapy on the function of malignant tumour patients and regulation function of AP]. Chen Tzu Yen Chiu 20(1):1-4. Inst of AP and Moxibustion, China Acad of TCM, Beijing, PRC. The observation on the indexes of cortisol, estradiol, estriol and testosterone showed that incretory function of malignant tumour patients had different extent of pathologic changes, after radiotherapy and chemotherapy, making the change strengthened. AP can regularize this disorder of incretory function of patients treated with radiotherapy and chemotherapy to some extent.

Yang_J4; Zhao R; Yuan J; Chen G; Zhang L; Yu M; Lu A; Zhang Z (1994) [The experimental study of prevention and treatment of the side-effects of chemotherapy with AP (comparison among the effect of AP at different AP point)]. Chen Tzu Yen Chiu 19(1):75-78. Inst of AP and Moxibustion, China Acad of TCM, Beijing, PRC. After ip injection of cyclophosphamide in rats, pathologic changes occurred in haemopoietic, immune and visceral function. AP at one of three different points decreased the above mentioned damage as follows: the effect of AP on haemopoietic function: GV14 >/= ST36, ST36 >/= BL23; the effect of AP on immune function: ST36 > GV14, GV14 >/= BL23; the effect of AP on the function of the liver and the kidney: BL23 >/= ST36, ST36 >/= GV14. The effect of AP at the combination of all 3 points (ST36 + GV14 + BL23) was better than that at any single point. There was no obvious effect when AP was given at non-AP points on the tail.

Yuan_J; Zhou R (1993) Effect of AP on T-lymphocyte and its subsets from the peripheral blood of patients with malignant neoplasm. Chen Tzu Yen Chiu - AP Research 18(3):174-177. Sch of Med of WCUMS, PRC. Effect of AP on the T-lymphocyte and its subsets from the peripheral blood of patients with malignant neoplasm was studied. 51 patients were assigned to 2 groups: 1=AP treatment and; 2=Control (untreated). 48 healthy adults were also studied as a normal control group. The % OKT3+, OKT4+, OKT8+ cells in the peripheral blood of the 51 patients were lower than those of the normal adults. After AP treatment, the percentages of OKT3+, OKT4+, OKT8+ cells were higher than before AP; untreated patients showed no significant variation. AP had more effect on OKT4+ cells than on OKT8+ cells. AP can be used as one of many treatments for patients with cancer.

Zhai_D; Chen H; Wang R; Hua X; Ding B; Jiang Y (1994) [Regulation on beta-End in tumour-bearing mice by moxibustion on CV04]. Chen Tzu Yen Chiu 19(1):63-65, 58. Shanghai Research Inst of AP & Channel, PRC. Tumour-bearing mice were assigned to 2 groups: 1=Moxibustion on CV04 and; 2=Untreated control. Results: Moxibustion on CV04 promoted hyperplasia of the pituitary and the adrenal gland which showed atrophy in the control group. Also, moxibustion stimulated the secretion of beta-End from the pituitary and the adrenal gland, increased the level of serum beta-End significantly and kept the level high for a long time. That allowed beta-End to carry out immunomodulation. Moxibustion did not cause instant release, but probably a constant release of beta-End.

Zhang_T; Gao C; Guo Y (1994) [Effects of moxibustion on the function of MDR gene product, P-glycoprotein (P-170)]. Chen Tzu Yen Chiu 19(2):69-71. Inst of AP and Moxibustion, Acad of TCM, Beijing, PRC. The experiments were performed on BABL/c mice with S-180R adriamycin resistant tumour cells. This animal model was used to analyze the drug accumulation in the S-180R cells by flow cytometer. The drug accumulation presents the pump activity of multidrug resistance (MDR) gene product P-glycoprotein (P-170) in the cell membrane, A weak inhibition was found when moxibustion at Guan-Yan point alone. And a very significant inhibition was observed in the presence of low-dosage of verapamil, but not at high dose. This study may develop a new way to research the mechanism of AP and moxibustion at molecular level, and may be useful to overcome the anticancer drug resistance.

Zhang_ZH4 (1986) Curative Effects Seen in 44 Cases of Radioactive Rectitis After Treating Cervical Cancer. Chin AP & Moxibustion Jun 6(3):18-19. (In Chinese). 44 cases of rectitis (inflammation, pain and bleeding of the rectum) caused by radiation therapy for cancer were treated by AP. 72% cases were cured, 9% cases were markedly effective, and 18% cases were improved. AP also produced analgesia and antipyresis, and reduced inflammation.

Zhao_R; Ma C; Tan L; Zhao X; Zhuang D (1994) The effect of AP on the function of macrophages in rats of immunodepression. Chen Tzu Yen Chiu - AP Research 19(2):66-68. Inst of AP and Moxibustion, China Acad of TCM, Beijing, PRC. Rats were immunodepressed by ip injection of cyclophosphamide. Their phagocytic % and phagocytic index of peritoneal macrophages (PM phi) as well as serum lysozyme (LSZ) decreased obviously; After 6 d of AP at ST36 (bilateral), PM phi phagocytic % and phagocytic index increased significantly, Serum LSZ showed no significant change. AP increased the phagocytic function of M phi in immunodepressed rats, but serum LSZ level did not synchronously increase with the phagocytic function of M phi.