About Ayurvedic treatment of lymphoma
Ayurvedic treatments for lymphoma offer a holistic and natural approach to addressing this serious condition. Ayurveda, an ancient Indian healing system, focuses on balancing the body and improving overall well-being. Ayurvedic therapies often include dietary changes, herbal remedies, detoxification, and stress reduction techniques. While Ayurveda can complement conventional medical treatments, it’s essential to consult with a healthcare professional to create a comprehensive treatment plan tailored to your specific needs. The personalized and holistic nature of Ayurveda may contribute to improved overall health and quality of life for individuals with lymphoma.
What is lymphatic system, and B-Cells, T-Cells and Natural Killers cells?
Lymphatic system is a vast network of lymphatic vessels, tissues, and organs. Lymphatic system plays most important function like maintaining the fluid balance, transporting immune cells, and removing the harmful substances from the body. The main components of lymphatic vessels include:
1) Lymphatic Vessels:
Lymphatic Vessels forms an extensive network of channels throughout the body, and it facilitates in collecting excess interstitial fluid (lymph). Lymphatic vessels also helps in eliminating waste products from the body.
2) Lymph:
Lymph is also called interstitial fluid, and is filtered out of blood capillaries into the surrounding tissues. Lymph contains immune cells like T and B Lymphocytes, and it further plays a crucial role in fighting against different infectious agents.
3) Lymph Nodes:
Lymph nodes plays one of the most crucial role in the immune system, and are small bean shaped structure that is situated throughout the lymphatic system. Lymph nodes acts as a a filtering stations, and helps to filter out pathogens, and dead and abnormal cells.
4) Spleen:
Spleen also plays a crucial function in immune system, and is the largest organ in the lymphatic system. It is located in the left upper abdomen, and helps to filter out dead and abnormal cells from the blood. It also provide site for hematopoiesis in earlier stages of gestation period in humans.
5) Thymus:
Thymus gland is located in the upper chest, just behind the breast bone, Thymus gland plays most crucial function in immune system by facilitating in maturation and development of immature T-Cells.
6) T-Cells:
T lymphocytes plays most important role in adaptive immune system of the body, and plays crucial role in protecting the body against different type of infectious agents and cancerous cells. Immature T-Cells from the bone marrow travels to the thymus gland for further maturation and development. There are three main type of T-Cells, and plays crucial role in immune system.
a) Helper T cells (CD4+ T cells): Helper T cells facilitates in regulating the immune system, and helps in activation of antibodies producing B Cells and cytotoxic T cells.
b) Cytotoxic T cells (CD8+): Cytotoxic T cells recognizes and directly kills infected cells, cancers cells etc. It induces cell death by directly releasing cytotoxic substances like perforin and granzymes.
c) Regulatory T cells (Tregs): Regulatory T cells (Tregs) helps in maintaining the immune tolerance and preventing excessive immune response so by preventing to auto-immunity.
7) B-Cells:
B Lymphocytes plays important and crucial role in adaptive immune system, and is responsible in producing antibodies. Antibodies are specialized proteins that can target and neutralize different foreign antigens. Few activated B cells differentiate into plasma cells. Plasma cells have capability of producing antibodies in large quantities same antigen-binding specificity as the original B cell and neutralize the antigens.
8) Natural Killer Cells (NK cells):
Natural Killer (NK) cells are type of innate immune cells that plays important role in body defense against bacteria, viruses and cancer cells. Unlike T and B cells, NK cells are not antigen specific and can facilitate in rapidly eliminating pathogens and neoplastic cells.
What is Lymphoma?
Lymphoma is a type of cancer that originates in the lymphatic system. As we all know that lymphatic system plays a crucial role in an individual immune system, and it consist of lymph nodes, lymph vessels, spleen and thymus. In Lymphoma, the lymphocytes acquires abnormal genetic mutation that gives its ability of sustained and unregulated proliferation or growth.
The abnormal and neoplastically modified lymphocytes (B -Cells, T – Cells, and or NK Cells) form cluster in the lymph nodes, and or other lymphatic tissues forming tumors. Abnormal lymphoma can spread to other part of the body through lymphatic system, and can prove life-threatening to the patients.
Types of Lymphoma
Lymphoma is a heterogeneous group of cancer that originate from the lymphocyte, and contain two main categories of lymphoma: 1) Hodgkin lymphoma (HL) and 2) Non-Hodgkin lymphoma (NHL). There are numerous subtypes within these categories based on distinct cytogenetic and morphologic features. The main types and subtypes are mentioned further:
1. Hodgkin Lymphoma (HL):
Hodgkin lymphoma is a type of cancer of the lymph nodes that is characterized by the presence of Reed-Sternberg cells. These cells are typically large and morphologically abnormal cells that is found within the lymph nodes, and other organs.
a) Classical Hodgkin Lymphoma (cHL):
- Nodular Sclerosis Hodgkin Lymphoma (NSHL)
- Mixed Cellularity Hodgkin Lymphoma (MCHL)
- Lymphocyte-Rich Hodgkin Lymphoma (LRHL)
- Lymphocyte-Depleted Hodgkin Lymphoma (LDHL)
b) Nodular Lymphocyte-Predominant Hodgkin Lymphoma (NLPHL):
This is a rare subtype of HL with unique features and a favorable prognosis.
2) Non-Hodgkin Lymphoma (NHL):
NHL is a more vast and diverse group of lymphomas, and is classified based on the types of lymphocyte involved (B cells, T cells, or NK cells). Some common types of NHL include:
- B-cell Lymphomas:
- Diffuse Large B-Cell Lymphoma (DLBCL): The most common subtype of NHL.
- Follicular Lymphoma (FL)
- Mantle Cell Lymphoma (MCL)
- Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL)
- Marginal Zone Lymphoma (MZL)
- Burkitt Lymphoma
- Waldenström Macroglobulinemia/Lymphoplasmacytic Lymphoma
- T-cell and NK-cell Lymphomas:
- Peripheral T-cell Lymphoma (PTCL)
- Anaplastic Large Cell Lymphoma (ALCL)
- Extranodal NK/T-cell Lymphoma, Nasal Type
- Adult T-cell Leukemia/Lymphoma (ATLL)
- Enteropathy-Associated T-cell Lymphoma (EATL)
- Primary Central Nervous System Lymphoma (PCNSL): This rare type of lymphoma originates in the brain, eyes, or spinal cord.
Lymphoma Statistics
Lymphoma is a type of a cancer of the lymphatic system. The lymphatic system plays a crucial role in the immune system. Lymphoma is 11th most common type of cancer diagnosed worldwide and an estimated 545,000 overall new cases of lymphoma was recorded worldwide. Approximately 260,000 deaths was attributed to lymphoma globally. Further is mentioned some statistics related to lymphoma:
1) Incidence: In India, 18,000 new cases of Hodgkin lymphoma and about 32,000 new cases of non-Hodgkin lymphoma was recorded in India in 2020.
2) Mortality: Lymphoma accounts for approximately 3.9% of all cancer-related deaths worldwide in 2020, and further categorizing that 25,000 deaths was attributed to Hodgkin’s Lymphoma. Non-Hodgkin’s Lymphoma was reason approximately 223,000 deaths globally. In India, approximately 5,600 deaths was attributed to Hodgkin lymphoma and 24,000 deaths to Non- Hodgkin Lymphoma.
3) Geographical Variation: It is well noted fact that incidence of lymphoma varies widely across the globe and has a higher incidence in developed nations or high income countries about 20 cases per 100,000 people. In less developed countries or low income nation approximately 10 cases was diagnosed per 100,000 people.
Causes of Lymphoma
Lymphoma is a type of cancer that originates in the lymphatic system, and various types and subtypes are included in the classification of the lymphoma. The exact cause of the lymphoma is still unknown but multiple factors can increase the predisposition to Lymphoma. These factors are:
1) Genetic Factors: There are known genetic factors and if they are mutated, then it can increase and individual to predisposition to lymphoma. Certain gene like BCL2, MYD88, CCND1, CD79B, MYC etc. can increase an individual predisposition to cancer.
2) Immunodeficiency: It is well known fact that individuals with compromised immune system are at an increased risk for lymphoma. Immuno-compromised conditions like HIV/AIDS, immunosuppressive therapy post organ transplantation etc. have a more predisposition to develop lymphoma when compared with control population. It is well fact that immuno-surveillance keeps the neoplastic transformed cells or cancer cells under check.
3) Infections: Further analysis in the causative factors of lymphoma has shown that viral and bacterial infections increases the risk of developing lymphoma. Viruses like Epstein-Barr virus (EBV) increases the risk of developing Hodgkin’s lymphoma, and Human T-cell lymphotropic virus type 1 (HTLV-1) can be linked to adult T-cell leukemia/lymphoma.
4) Age and Gender: It is well known and proven fact that the risk of developing lymphoma increases as the age progresses. And certain gender have a more pre-disposition in developing certain subtypes of lymphoma.
5) Obesity and lifestyle: Obesity is well known to contribute to increased risk of developing lymphoma, and many other types of cancer. Sedentary lifestyle and smoking increases an individual predisposition in developing lymphoma.
Other known risk factors are chemical and radiation exposure that increase an individual risk to developing lymphoma, and many other types of cancer. It is most important to note that presence of a risk factors does not warrants the development of lymphoma, and individual who are without any known risk factors can also develop lymphoma.
Symptoms of Lymphoma
Symptoms of the Lymphoma can vary between two main type and the stage of the Lymphoma: 1) Hodgkin Lymphoma. 2) Non-Hodgkin Lymphoma. But certain common symptoms are mentioned below:
1) Enlarged Lymph Nodes: One of the most common presentation in lymphoma is the presence of enlarged lymph nodes. Affected lymph nodes are swollen and enlarged but are firm and painless to touch.
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2) Fatigue: Unexplained and persistent fatigue is fairly common symptom that is present across all types and subtypes of Lymphoma. Fatigueness in lymphoma generally does not responds to conventional line of symptoms, and can be explained due to immune response of the body to the cancer cells.
3) Unexplained weight loss: Unexplained, gradual and rapid loss of weight is also one of the most common symptom in lymphoma. Weight loss is usually not linked to changes to diet and exercise.
4) Fever: Persistent and unexplained fever can be a symptom of Lymphoma mostly in Hodgkin’s Lymphoma. Fever can vary across the day, and generally varies in intensity.
5) Night Sweats: Generally intense night sweats is a characteristic symptom of lymphoma. Night sweats is generally unrelated to other factors, and is drenching through clothes and bedding.
Other symptoms of lymphoma is itching, pain, anemia and loss of appetite. It is also important to note that having a particular symptom does not necessarily mean that you have lymphoma. Kindly connect with your healthcare provider for further advice.
Treatment of Lymphoma
Treatment of lymphoma varies on multiple factors like types, and its subtypes, stage of the lymphoma at which it is diagnosed and overall general health of the patients. In the current era, patient’s preferences is also taken into consideration. Multiple treatment modalities are available for treatment of lymphoma:
1) Chemotherapy: Chemotherapy is the most common treatment modality employed in the treatment of cancer. Chemotherapy involves employing use of cytotoxic drugs which is administered intravenously, and or intrathecally.
2) Radiotherapy: Radiotherapy involves use of high energy rays to target and kill the lymphoma cells. Radiotherapy is mostly employed in localized tumors or shrink the size of the tumors.
3) Immunotherapy: Immunotherapy involves using monoclonal antibodies, CAR T-cell and checkpoint inhibitors for treatment of lymphoma. Immunotherapy facilitates immune system to fight lymphoma cells.
4) Bone marrow transplant: It involves replacing the damaged or abnormal marrow cells with health marrow cells through bone marrow transplantation. Bone marrow transplantation can be often curative in Lymphoma.
5) Targeted Therapy: Targeted therapy involves using drugs that targets certain molecules or pathways that is necessary for survival and proliferation of cancer cells.
Ayurvedic Treatment in Lymphoma or आयुर्वेद में लिंफोमा
In Ayurveda texts, no such specific term designating lymphoma is mentioned or described, but its ‘Dosha Samprapti or Etiopathology’ can be compared with the topic or roga called ‘Vishama Jwara/ विषम ज्वर’. When the same dosha and dushya samprapti as mentioned in Vishama Jwara/ विषम ज्वर resides in Rasa Dhatu or lymph nodes or lasika it is called ‘Lymphoma/ लिंफोमा’.
Under category of Vishama Jwara/ विषम ज्वर, 5 different types of ज्वर/Jwara is mentioned: 1) Santata Jwara. 2) Satata Jwara. 3) Anyedyushka Jwara. 4) Tritiyaka Jwara. 5) Chaturthaka Jwara.
1) Santata Jwara: In santata jwara vitiated or aggravated doshas circulate through rasavaha strotas and spread all over the body, and causes santata jwara. By nature of the disease santata jwara is extremely difficult to treat, and shows its symptoms very quickly.
2) Satata Jwara: In satata jwara vitiated or aggravated doshas circulate through rakthavaha strotas and spread all over the body, and further cause’s satata jwara. Satata Jwara manifests twice in 24 hours.
3) Anyedyushka Jwara: Anyedyushka Jwara vitiated or aggravated doshas circulate through medovaha strotas and spread all over the body, and further cause’s anyedyushka jwara. Anyedyushka Jwara manifests only once during day and night.
4) Tritiyaka Jwara: Tritiyaka Jwara vitiated or aggravated doshas circulate through asthivaha strotas and spread all over the body, and further cause’s tritiyaka jwara. Tritiyaka jwara fever manifest after a gap of one day.
5) Chaturthaka Jwara: Chaturthaka Jwara vitiated or aggravated doshas circulate through majjavaha strotas and spread all over the body, and further cause’s chaturthaka jwara. Chaturthaka jwara fever manifest after a gap of two days.
Concept of Lasika and Rasavaha Strotas, and its relationship in Etiopathology or Samprapti of Lymphoma
Lasika
Lasika or lymph is one of the major constituents of the body, and part of the watery component of the body popularly known as udaka dhatu in Ayurveda. Lasika is told to be involved into the pathogenesis of many skin and systemic disorders like Kustha (different skin ailments), Visarpa (Herpes), Prameha (Diabetes Mellitus) etc.
Lasika resides in the skin and circulates throughout the body. In panchabhautik description of lasika it has a predominance of apa mahabhuta and pitta dosha. As per different Ayurvedic texts, lasika can be either an updhatu or mala of rasa dhatu. Lasika is vitiated or aggravated in multiple disorders like Kaphaj Kustha, Kaphaja Shotha etc. Importance of Lasika in Lymphoma is that Lasika or Lymph circulates through lymph nodes and lymph vessels. As already described Lasika is part of a rasa dhatu so lymph vessels and lymph nodes can be called Rasavaha Strotas. And lymphoma is a disorder of Rasavaha Strotas or Rasa Dhatu.
Rasavaha Strotas
रसवहानां स्रोतसां हृदयं मूलं दश च धमन्यः|
The rasavaha strotas has its origin in hridaya or heart, and dashadhamanis (ten major arterial trunks).
गुरु शीतमतिस्निग्धमतिमात्रं समश्नताम्| रसवाहीनि दुष्यन्ति चिन्त्यानां चातिचिन्तनात्|
Dusthi or vitiation of Rasavaha Strotas is caused due to patient who consume heavy food, cold food, over snigdha food, and excessive food. Vitiation of rasavaha strotas is also caused due patients who take excessive mental stress or involved into stressful activities.
Jwara as per Ayurveda is caused due to dusthi or vitiation of doshas in Rasa Dhatu, so dusthi of lasika and rasavaha strotas plays a vital role in etiopathology or samprapti of lymphoma.
Treatment of Lymphoma/लिम्फोमा in Ayurveda
The main goal of Ayurveda therapy is to find the cause of the Lymphoma/लिम्फोमा, while the therapeutic approach of Ayurveda is simply divided into two major categories
1) Oral Medications
2) Panchakarma.
Oral medications
1) Putapakwa Vishama Jwarantak Lauh (पुटपक्व विषम ज्वरान्तक लौह) in Lymphoma
Vishama Jwarantak Lauh (Putapakwa) is prepared from different minerals and metallic contents mentioned in Ayurveda. It is mentioned in Rasendra Sara Sangraha Jwara Adhyaya. The contents of Vishama Jwarantak Lauh (Putapakwa) is Shuddha Parada, Suddha Gandhaka, Swarna Bhasma, Lauh Bhasma, Tamra Bhasma, Vanga Bhasma, Pravala Bhasma, Abhrak Bhasma, Shukthi Bhasma, Shanka Bhasma, and Mukta Bhasma. This mixture is taken in a mukta sukhti and laghu puta is given. After it is let to cool down and Vishama Jwarantak Lauh (Putapakwa) is extracted.
Putapakwa Vishama Jwarantak Lauh proves beneficial in treatment of multiple types of fevers which are intermittent or chronic in nature. It also proves beneficial in splenomegaly, anemia, and edema. Putapakwa Vishama Jwarantak Lauh also proves beneficial in cachexia, persistent diarrhea and vomiting.
2) Vranapahari Rasa (व्रणापहारी रस) in Lymphoma
Vranaphari Rasa is a herbo-mineral formulation mentioned in Rasayogasagar. As name suggest Vranaphari Rasa is good in wound healing, and this actions of its proves beneficial in many ailments. Vranaphari Rasa proves beneficial in oral medications as Vrana (wound), nadivrana (sinus), and bhagandara (fistula). The major contents of Shuddha Parada (Purified Mercury), Shuddha Gandhaka (Purified Sulphur), Shuddha Hartala (Arsenic Trisulphide – AS2O3), Shuddha Manashila (Arsenic Disulphide – AS2S2).
Vranaphari Rasa through its rasayana action helps is tissue regrowth of the wound, and help to ameliorate the chronic inflammation associated with wound, and the same principle applies over the treatment of lymphoma. It has also being proven that arsenic compounds proven beneficial in lymphoma and leukemia but safe administration of arsenic compounds is always a concern but arsenic formulations like Vranaphari Rasa can be safely administered in Lymphoma cases.
3) Kanchanar Guggul (कांचनार गुग्गुलु) in Lymphoma
Kanchanar Guggul is a polyherbal Ayurvedic medication, and is prepared from 12 different herbs. The contents of Kanchanar Guggul is Bauhinia variegata (Kanchanar), Terminalia chebula (Haritaki), Terminalia bellirica (Vibhitaki), Emblica officinalis (Aamlaki), Zingifer officinale (Sunthi), Piper longum (Pippali), Piper nigrum (Maricha), Elettaria cardamomum (Ela) etc, The above mixture is titrated with water, and tablet of 250 mg is prepared.
Kanchanar Guggul possess anti-oxidant, anti-bacterial, and anti-cancer properties. Due to its cytotoxic activities it regulate cell division, and ameliorate cell proliferation. Kanchanar Guggul possess special activity in lymph node swelling due bacterial and viral infections, and many other etiopathology. Kanchanar Guggul helps to clear toxins of lymphatic system, and so proves beneficial in Lymphoma. Kanchanar Guggul can also be administered in children’s.
Purgation or Virechana Karma (विरेचन कर्म) in Lymphoma Patients
If we see predominance of pitta dosha in lymphoma patients or doshas is still in apakvastha awastha, the mrudu virechana can be given to the patients. Virechana Karma is one of the purification therapies mentioned under Panchakarma in Ayurveda. Virechana Karma mainly focusses on eliminating excessive dustha doshas mainly pitta dosha and toxins from the body. Virechana Karma involves administration of purgative medications to induce controlled and gentle purgation which eventually stops on its own.
Virechana Karma involves poorva karma or preparatory phase in which oleation of the patient is done through medicated ghee which help in liquefying the dustha doshas and transporting the toxins toward gastrointestinal tracts for further elimination through administration of purgative drugs.
Virechana Karma helps in balancing Pitta Dosha and improving digestion of the lymphoma patients. It even enhances metabolism, and promote mental and physical well-being of lymphoma patients.
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