| Cancer ranks among the most common and most lethal malignancies worldwide and approximately7million of new cases and5million of death attributes to it annually. In China, approximately2-3million new cancer cases are diagnosed,1.6-2million of deaths relates to cancer and the annual maintainance cancer patients keeps about2.5-3millions. Cancer is also one of the most common diseases in the elderly population in China. It presets the highest incidence in metropolis and the second in rural area. The incidence of cancers, including lung, GI tract, breast, cervical, ovary, et al. is rising rapidly.The population is about1.3billion in our nation, among which144million are over the age of60. As for no able to be detected, diagnosed and treated in time or in early time, the patients in milled and advanced stages are commonly-seen in clinic or more than80%of initial diagnosed patients defined to middle or late stages according to statistic.Apart from limited technology, late clinic consultation, mis-diagnosis and mis-management are also fundamental obstacles to improving cancer outcoms. Due to the factors like highly aged, poor body constitution, advanced stage, multi-symptoms, multi-complications and in severe grave, they bear poor quality of life, short life-span, and passing away within one year in general.Statistically, the cost of medic and medicare exceeds more than RMB100billion Yan annually (RMB100thousand per cancer patient, so RMB200-300billion Yan out of2-3million cancer patients). We medical staffs have to think about and solve the tough in front of us.Over the past40years, the principles and practices of cancer by TCM and integrative medicine is more and more acceptable by both medical stuffs and patients.Through accumulative clinical trial and laboratory experiments, it has been approved that TCM takes it active and promising effects for cancer patients in terms of immune system, anticancer ability, side effects relating to chemo and/or radiation, disease stabilization, quality of life and life span. The Object of the StudyIn the process of the study of "master and apprentice", the rich experience of master’s on management of advanced cancer patients in the aspects of reliving the painful, the side effects, improving QOL, prolonging TTP and life span gave me deep impression, that is why I choose the topic.The reasons why the elderly is susceptible to cancer stricken:1The generation of cancer, in fact, is a long-term pathological process, which may last10-15years even20-30years from a biological cell to a cancer cell, so the onset time commonly presents over50-60years.2As to deteriorating biological function, disordering endocrine system, descending immune function of the aged as 《Internal Meridian》 states:"The deficiency and impairment of the kidney function of the elderly lead to that of all the other organs",《Ling Shu》:"of the sixtieth, the heart Qi begin weakening; of the seventieth, spleen Qi begin in deficiency, of the eightieth, deficiency; of ninetieth, failure, of the hundredth, all the organs lose their biological functions at all." so the incidence of cancer rises due to the reasons.3The causations like the mental distress for a long time, comorbidities, the environmental pollution of working’s and reside’s, contaminated food, heavy smoking, high-dose alcoholic consumption, unhealthy life habit, could also accelerate the generation and development of cancers.The aged population is more prone to esophageal cancer, gastric cancer, lung cancer, CRC, HCC, cervical, breast, prostate cancer, et al. The study of esoteric academic thought of muster’sA."weakening body constitution and excess of evil elements" is the specific pathology in the elderly cancer patients with advanced stage. For the elderly, the deficiency of both blood and Qi and impairment of visceral organs turns to be in clinic manifestation as 《Internal Meridian》 noted:"The pathogenesis could not attack the body if the immune defence is strong enough in it, otherwise, the defence power would be weakened if the exterior evil factors enclose or exist around the body for a little bit longer." The excess of evil elements refer to those patients in advanced stages with severe disease, disease relapse, metastasis, tumor size in progression, symptoms in emergency, mental tension and distress, sharp temper, et al.B. Strengthening the body resistance and consolidating the constitution (SBRCC) as first; anti-cancer and detoxication (ACD)as adjuvant are the primary management for the elderly in advanced stages.SBRCC is one of the primary multiple disciplinaries of TCM which is embodied on the other primary theory of TCM like wholeness, haven and human being in harmony and the balance of Yin and Yang. The pathogenetic nature of the elderly in advanced stages refers to deficiency as the classic medical work 《Yi Zong Bi Du》 noted:"Where that tumor formed emerges deficiency of defence power and at where exterior oncogene attack",《Wai Ke Yi An》:"Cancers are formed upon deficiency of blood and Qi" that strongly back to the regulation of close relationship between the developing cancers and the impairment of body resistance. So the practice in clinic and study of SBRCC have turned to be the leading way in terms of prevention and treatment of cancers by TCM as well as a creation in the nation.SBRCC includes replenishing Qi and blood, invigorating the spleen and regulating the stomach, nourishing the liver and kidney.ACD encloses regulating the flow of Qi and blood, promoting the blood flow to remove the obstruction in collaterals, dispelling phlegm and removing dampness, softening hardness and dispelling nodulars, detoxicating evil elements and reliving the pain.C. Limiting symptoms, reliving the painfulness promoting QOL and prolonging life span are the major targets of management for the elderly in advanced stages.From the rich clinical experience of my teacher’s, it has proved that the major disciplinary management for this kind of patients should high-light on promoting the QOL and reliving the most sufferings presented on clinic and conduct the treating approaches with TCM that patients could be able to afford in expense and to stand physically under the premise of less painfulness to patients and less impairment of immune system.Over the past two decades, the acknowledgement of cancer has been radically taken place from the view of oncologists worldwide, which believe that cancer is a sort of chronic disease and not be rooted out in necessary only no pain or less pain is good enough for cancer patient to keep alive.D. Acceptable approaches of Integrative Medicine is the primary way of boosting treating efficiency. In the past more than ten years, the cancer institutes nationwide treated the elderly, by Integrative Medicine, with lung, stomach, breast, cervical cancer as well as CRC, HCC, NPC, et al and gained a better results comparing with each single approach TCM or Western medicine. The survival rates of1y,3y and5y wre all improved in a certain degree.E. RehabilitationRehabilitation is also one of the primary parts of management of elderly cancer patients, which increase confidence of patients’to win the war to cancer evil and get rid of the awareness that cancer means death.ConclusionThrough the esoteric individual academic study of Professor Zhang’s results in the following regulations conductiog clinic practice:a Integrating the treatment based on differenciation of symptoms and signs of TCM and differenciation of diseases of western medicine.b Integrating the local practices and the systemic ones.c Integrating clinic practice and laboratory study.d Applying the comprehensive disciplines which are acceptable, systemic, being able to stand physically and afford from pocket, in order to limit symptoms and relieve the sufferings for the elderly cancer patients in advanced stages, promoting QOL prolong the life span and improve the death rate. |
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