Treating Chemotherapy Induced Nausea and Vomiting (CINV): A Chinese Medicine Perspective
What is Chemotherapy Induced Nausea & Vomiting
The cause of nausea and vomiting resulting from chemotherapy is not well understood, and the use of antiemetic drugs to treat CINV may lead to further unwanted side effects [1]. Chemo can cause nausea and vomiting by two major ways – peripheral or central mechanisms. In response to chemotherapy, enterochromaffin cells in the gastrointestinal tract release serotonin which starts the syndrome of chemotherapy-induced nausea and vomiting (CINV).
Serotonin stimulates vagal afferent nerves which communicate with the brain. Through the dorsal vagal complex, the brain communicates back to stomach causing reverse peristalsis, which results in nausea and vomiting (NB: In Chinese medicine this is termed Rebellious Stomach Qi). Centrally, stimulation of the neurokinin 1 (NK1) receptors by substance P in the brain- stem can also lead to CINV.
Nausea and vomiting are the most common complications following chemotherapy treatment and usually lead to decreased quality of life. Acupuncture therapy is a safe and effective method for CINV [1,2].
In China, Traditional Chinese Medicine (TCM) has been extensively used for thousands of years and applied in various diseases. Acupuncture’s ability to stimulate the body to release natural endogenous opioids (endorphins) and neurotransmitters or neurohormones, can reduce the nausea and vomiting resulting from chemotherapy treatment without the risk of further side effects [3].
At Kurrajong Natural Medicine Centre our highly qualified and experienced practitioners are ready to help. Simply call (02) 4573 0784 to discuss what approach is best for your health issue.
How Does Traditional Chinese Medicine (TCM) view Chemotherapy Induced Nausea & Vomiting (CINV)
In Australia Chinese medicine practitioners are not permitted by law to treat cancer specifically. However, when treating a patient, a doctor of Chinese medicine must consider the patterns existing in the patient holistically. Therefore, while reducing nausea and vomiting is the primary focus, treatment for CINV will inevitably also affect the underlying factors of stagnant qi, blood and the accumulation of phlegm, as these are also part of the nausea and vomiting that results from chemotherapy drugs. During chemotherapy the attention is to strengthen the defensive energy (Zheng Qi) in the body [4].
Traditional Chinese Medicine (TCM) has its own unique perspective on chemotherapy-induced nausea and vomiting (CINV). In TCM theory, health is believed to be maintained by the harmonious balance of Qi (vital energy), Yin and Yang, and the proper functioning of organ systems. When illness or discomfort occurs, it is often seen as an imbalance or disruption in these energetic forces.
From a TCM perspective, CINV is generally attributed to a disharmony or imbalance in the body’s Qi and organ systems, particularly the Stomach and Spleen. Chemotherapy drugs are considered to be strong toxins that can disrupt the body’s natural balance and lead to Qi stagnation, dampness, and phlegm accumulation. This disruption can cause symptoms such as nausea, vomiting, loss of appetite, and fatigue.
The treatment of CINV in TCM aims to restore balance and harmony within the body. TCM practitioners may use a combination of acupuncture, herbal medicine, dietary recommendations, and lifestyle modifications to address CINV. Here are some common approaches:
Acupuncture: Fine needles are inserted into specific acupuncture points to help regulate the flow of Qi and restore balance. Acupuncture is believed to stimulate the body’s natural healing mechanisms and alleviate nausea and vomiting.
Herbal Medicine: TCM herbal formulas may be prescribed to strengthen the digestive system, regulate Qi flow, resolve dampness, and reduce nausea and vomiting. The specific herbs used will depend on the individual’s symptoms and overall constitution.
Dietary Recommendations: TCM emphasizes the importance of proper nutrition and a balanced diet. TCM practitioners may provide dietary recommendations tailored to the individual’s condition, such as avoiding greasy or spicy foods and focusing on easily digestible, nourishing meals.
Lifestyle Modifications: TCM views lifestyle factors as essential for maintaining health. Recommendations may include stress reduction techniques, gentle exercise (such as qigong or tai chi), and adequate rest to support the body’s healing process.
What You Can Do to Help Yourself to Reduce CINV
Some therapies have been proven to be safe and effective in scientific studies. For example, therapies such as meditation, relaxation, massage and counselling can reduce anxiety, and acupuncture can reduce chemotherapy-induced nausea and fatigue [5].
- Eat frequent, small, meals during the day. Vegetable Soup is particularly good, nourishing meal that can be consumed in small quantities.
- Apply strong pressure to PC.6 – an acupuncture point approx. 5cm from your wrist crease. Apply pressure and push finger along the middle of the forearm toward the wrist crease. Repeat this several times or until nausea is reduced/alleviated
- Consult a qualified Chinese medicine practitioner to provide you with acupuncture and/or Chinese herbs
- Use relaxation techniques to help relax your body and mind – Download a Guided Relaxation Here
References
Ma, T. T., Zhang, T., Zhang, G. L., Dai, C. F., Zhang, B. R., Wang, X. M., & Wang, L. P. (2020). Prevention of CINV with acupuncture: A protocol for systematic review and meta-analysis. Medicine, 99(3), e18828. https://doi.org/10.1097/MD.0000000000018828
Li, Qw., Yu, Mw., Yang, Gw. et al. Effect of acupuncture in prevention and treatment of chemotherapy-induced nausea and vomiting in patients with advanced cancer: study protocol for a randomized controlled trial. Trials 18, 185 (2017). https://doi.org/10.1186/s13063-017-1927-2
Huang, Y., Zhang, R., Yao, Q., Liu, J., OuYang, X., Hui, X., Wang, H., He, R., & Zhao, B. (2020). Acupuncture treatment for chemotherapy-induced nausea and vomiting: A protocol for systematic review and meta-analysis. Medicine, 99(21), e20150. https://doi.org/10.1097/MD.0000000000020150
Maciocia, G. The Treatment of Cancer with Chinese Medicine. URL: https://giovanni-maciocia.com/the-treatment-of-cancer-with-chinese-2/ last visited 7th July 2021
Cancer Council Victoria. Chemotherapy: Trying complimentary therapies. URL: https://www.cancervic.org.au/cancer-information/treatments/treatments-types/chemotherapy/side_effects_of_chemotherapy.html last visited 7th July 2021.
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