Chinese Medicine Gem

Metastatic liver cancer is the most common type cancer caused by colon cancer, which has spread to the liver. According to the studies based on autopsy, the results showed that up to 70% of colon cancer patients have metastatic liver cancer at autopsy.

Because the colon cancer cells have spread to elsewhere in the body, the surgery is unlikely to eliminate them all. The worse is that sometimes after the surgery the colon cancer will come back in the bowel again, which can grow and completely block the bowel. In such case, the patients tend to have symptoms such as severe constipation and vomiting large amounts.

Methods to relieve constipation by metastatic liver cancer

To relieve the symptoms of constipation and vomit, according to western medication, there are two methods available as follows:

• First the bowel can be unblocked by putting in a tube called a stent;
• Second way is the surgery, in which the affected part of the bowel would be removed to unblock the bowel.

Apparently these two methods can lead another pain to the cancer patients. They have suffered too much and deserve a better way to relieve their pain. From the point of view of Chinese medicine, constipation and vomit caused by metastatic liver cancer, combined with other symptoms, must to be put into consideration to make a successful diagnosis.

The following is a typical case of constipation after metastatic liver cancer surgery and show you how the diagnosis proceed based on the theory of Six Channels in Chinese medicine.

Case of severe constipation after metastatic liver cancer surgery

Guo, male, 63-year-old man.
There was severe constipation one week after the metastatic liver cancer surgery. The physician prescribed lactulose and ever tried with enemas, but both of them failed to unblock the bowel.

Chief Complains:

• Severe constipation;
• Feeling bloated and full in lower abdomen;
• Pain;
• Bitter mouth and desire to vomit;
• Dry mouth and desire to dink;
• Chest tightness and shortness of breath;
• Orthopnoea;
• Irritability and insomnia;
• Palpitations;
• Occasional dizziness;
• Headache (with high blood pressure);
• Distension over the whole abdomen;
• No fart;
• Pain in lower abdomen when touched with hand;
• Feel hard in the part of stomach when touched with hand;
• Muscle both below the costal region feels tension and sensitive;
• Dark tongue in tone, with white, greasy, and slight yellow coating;
• Deep and astringent pulse.

Syndrome differentiation of constipation after metastatic liver cancer surgery

At the first glance, all the syndrome of constipation, distension over the whole abdomen, no fart, irritability and insomnia lead it to the scope of Da Cheng Qi Tang. However the patient of metastatic liver cancer complained mainly in pain, distension and fullness in lower abdomen, which can rule out the possibility of Da Cheng Qi Tang. And the deep and astringent pulse should indicate that stasis of blood and stagnation of food toxicity in vessels and channels, instead of Yin deficiency syndrome. Combined with other symptoms and tongue diagnosis, there is no doubt that it should be a Yang excess syndrome.

• Feel hard in the part of stomach when touched with hand;
• Severe constipation;
• Muscle both below the costal region feels tension and sensitive;
• Bitter mouth and desire to vomit.

The above-mentioned symptoms point to the disease involving in both channels of Shao Yang and Yang Ming, which fall into the scope of Da Chai Hu Tang (Major Bupleurum Decoction).

• Feeling bloated and full in lower abdomen;
• Pain in lower abdomen when touched with hand;
• Irritability and insomnia;
• Palpitations;
• Chest tightness and shortness of breath;
• Orthopnoea;
• Occasional dizziness;
• Headache (with high blood pressure).

The above-mentioned symptoms point to blood stasis in lower Jiao and uprush, which fall into the scope of Tao He Cheng Qi Tang.

• Dry mouth and desire to dink;
• Irritability.

The above-mentioned symptoms point to Yang Ming syndrome, namely the presentation of Shi Gao (Gypsum fibrosum).

Diagnosis: Disease involving in both channels of Shao Yang and Yang Ming, accompanied with blood stagnation in lower Jiao and uprush.

Treatment: Unblock the bowel, dispel the stasis of blood and reconcile Shao Yang.

Formulas: Da Chai Hu Tang and Tao He Cheng Qi Tang plus Shi Gao

• Chai Hu (Bupleurum) 12g;
• Huang Qin (Scutellaria baicalensis) 10g;
• Ban Xia (Pinellia Rhizome) 12g;
• Zhi Shi (Aurantii Fructus immaturus) 10g;
• Bai Shao (Paeoniae Radix alba) 12g;
• Da Zao (Jujubae Fructus) 4 pieces;
• Sheng Jiang (Zingiberis Rhizoma recens) 10g;
• Dang Huang (Rhei Radix et Rhizoma) 10g;
• Tao Ren (Persicae Semen)12g;
• Gui Zhi (Cinnamomi Ramulus) 10g;
• Mang Xiao (Natrii Sulfas) 12g (mixed with boiled decoction separately);
• Zhi Gan Cao (Glycyrrhizae Radix preparata) 10g;
• Shi Gao (Gypsum fibrosum) 45g.

Notes:

• 3 doses in total;
• A few amount each time with frequency service;
• Stop it once bowel unblocks.
• Due to the patient of metastatic liver cancer has nausea and desires to vomit, it should use ginger to rub the tongue if he wants to vomit during drinking decoction. But pay attention not overdo it and it is appropriate as long as not to spit decoction.

After finishing two doses intermittently the first day, the patient felt a little improved with sound sleep but constipation remained. The following day just one hour after he finished the decoction, he felt discomfort in abdomen and soon relieved large amount of black and smelling bowels, including 6 to 7 hard stools. He felt extremely comfortable after that and acclaimed this medicine as a ready-made panacea.

Because there were still symptoms such as dry mouth and bitter mouth, the patient of metastatic liver cancer needed to continue taking another 3 doses of Da Chai Hu Tang and Gui Zhi Fu Ling Wan plus Shi Gao for cleanup.

Metastatic liver cancer is unlikely to be cured, but Chinese medicine can help relieve the symptoms of severe constipation and improve the life quality. Of course, all need to be based on a successful diagnosis first. Now you see that how important the syndrome differentiation is in Traditional Chinese medicine therapies.