What is Lung?
Before explanation about lungs we just want to told that Ayurveda for lung cancer involves a wide range of therapies, which can help control symptoms and improve quality of life. Lungs are the primary organ responsible for respiration, or as a common man would call it “breathing”. Lungs are located in your Thorax or chest and perform most Vital function of gaseous exchange. Which inhalation of oxygen (O2) and exhalation of Carbon dioxide (CO2) to put in short. Each lung are further divided in lobes, right lung consisting of three lobes and left one consisting of two lobes. Air in the lungs travels through trachea (windpipe), into the Bronchial tree which is further divided into branches called bronchi. Bronchi is further subdivided into bronchioles and end into small air sacs or respiratory units called alveoli or alveolus. Alveoli is the place where gaseous exchange takes place. Lungs are surrounded by thin layer of membrane called as pleura.
What is Lung Cancer?
Lung Cancer is a type of cancer that originates in the cells of the lungs. It is one of the most common type of cancer not only in India but worldwide too. Lung cancer is responsible for more cancer related deaths than any other cancer. Development of lung cancer is a multistep process and involves series of genetic and epigenetic mutations where resulting molecular changes further leads to transformation of normal lung epithelial cells into cancer cells. Statistically, tobacco smoking is the most prominent cause of the lung cancer, but also we also have to note that 20% of cases of Lung cancer are non-smokers or people who have smoked less that 100 cigarettes in their lifetime.
Lung Cancer in Never Smokers (LCNS) pose a major public health problem and is seven most common cause of cancer related deaths. LCNS have fewer genetic and epigenetic mutations and its incidence peaks mostly in young age. The major causes of LCNS remains unknown but other environmental carcinogens and second hand smoking can play a major role in its incidence.
Lung Cancer Statistics Worldwide
According to the World Health Organization (WHO), cancer of the lung is the most common form of cancer worldwide and India. It accounts for approximately 11.6% cases of all cancer cases recorded globally. Lung Cancer is also leading cause of cancer related deaths noted worldwide accounting for nearly 18.4 % of all the deaths globally due to cancer.
In year 2020 it was estimated that overall 2.2 million cases of lung cancer was recoded globally, and overall estimated 1.8 million deaths occurred due to lung cancer. Incidentally, majority of lung cancer related deaths belong to low and middle income groups.
Due to wide differences in tobacco smoking habits and exposure to other carcinogens or other risk factors, the incidence rate of lung cancer was found to be more in region of Europe and North America. But low cancer rates were noted in Africa and Asia. Historically lung cancer survival rates is relatively low and 20% of patient survive beyond 5 years or more after diagnosis. However, survival rates varies widely depending upon stage and type of the lung cancer. The key to improved survival and favourable prognosis is early detection and appropriate treatment in patients with `lung cancer.
Lung Cancer Epidemiology
Epidemiology refers to the study of distribution and determinants of a disease in a given population. Evaluation and better understanding of epidemiology is important for developing and improving better, and effective treatment strategies. The incidence of lung cancer is higher in men than in women, and increases with age. In developed countries, the majority of lung cancer cases occur in people more than age of 65 years.
Tobacco smoking is one of the leading cause of lung cancer, accounting for approximately 85% of all cases noted. Smoking is also even leading death worldwide considering all the known factors. It is estimated that smoking will cause at least 1 billion deaths in 21st Century and have left at least 100 million dead’s in 20th Century. All forms to tobacco have negative health impact and the severity can vary among its different products.
Individual who smoke tobacco is generally 15 to 30 times more at a risk of developing lung cancer compared to general population. Other risk factors for lung cancer include exposure to second-hand smoke, radon gas, asbestos, air pollution, and occupational exposures.
Lung Cancer Causes
The main causative factor of lung cancer is smoking cigarettes, cigars, or pipes. Tobacco smoking is responsible for more than 85% of all cases of lung cancer. Tobacco, when burned produces harmful chemicals which leads to the development of lung cancer by causing DNA damage.
Second hands smoker are who are exposed to smoke exhaled by smokers or given off by burning tobacco products also increases the risk of developing lung cancer by causing DNA damage. People who live more with smokers are high risk of developing lung cancer than people who do not.
Radon gas is another important cause of lung cancer and it is a naturally occurring gas that seeps from the ground into the home, and the buildings. Exposure to high levels of radon over a period of time can cause lung cancer. Exposure to certain chemicals and substances, such as asbestos, arsenic, diesel exhaust, and some metals, can also increase the risk of lung cancer.
It is a well-known fact that lung cancer can even happen in individuals who never smoked or not even exposed to known risk factors and carcinogens. Such cases are caused by inherent or acquired genetic mutations, or many other factors are yet to be known or studies.
The best way to prevention of lung cancer is to avoid smoking and to keep safe from exposure to second hands smoking or other known carcinogens.
Symptoms of Lung Cancer
Lung Cancer can show wide range of symptoms, ranging from no symptoms in its early stage till debilitating symptoms in advanced stages. Further we will elucidate most common symptoms of Lung Cancer: –
- Persistent Cough: A cough that persist and progressively worsens, and even doesn’t responds to conventional management or line of treatment.
- Shortness of breath or dyspnoea: Difficult in breathing or shortness in breath even while performing day to day daily routine activities or simple task which an individual previously could do it easily.
- Unexplained Weight Loss: Unexplained weight loss normally more than 10% of the total weight which was noted previously without even attempting to do so in a short period of time.
- Loss of appetite: Loss of hunger or not wanting to consume the amount of food which one used to do so.
- Coughing up blood: Blood in the sputum.
Other common symptoms are chest pain, hoarseness, fatigue etc.
It is important to note that all the above mentioned symptoms could be present in wide range of diseases and so it is important to consult a health care provider.
Lung Cancer Types
There are two main types of lung cancer: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). These type of classification depends upon the characteristics of the cells in the lung cancer based on immunophenotype and the altered gene expression profile, and also on the appearance of the cancers cells under microscope.
Symptoms of Lung Cancer
1) Non-Small Cell Lung Cancer (NSCLC):
NSCLC is the most common type of lung cancer, accounting for about 85% of all cases. There are three subtypes of NSCLC:2) Small Cell Lung Cancer (SCLC):
Small Cell Lung Cancer (SCLC) accounts for almost about 15% of all Lung Cancer cases. It is more aggressive in nature and tends to metastasize or spread to other parts of the body quite early in their stage of progression. SCLC shows a strong association with tobacco smoking.
Other rare type of lungs cancers include carcinoid tumors, mesothelioma etc. Carcinoid tumors are slow growing tumors and typically does not spread to other parts of the body. Mesothelioma is a rare type of cancer and affects the linings of the lungs. Asbestos is one of the major causative factor of mesothelioma.
Lung Cancer Stages
Lung cancer stages is used to describe the extent of the disease, to determine about the probable prognosis on the basis of data and statistics available and to guide treatment decisions. There are several staging systems available for lung cancer, but most commonly used system is TNM (Tumour, Node and Metastatis) staging system developed by the American Joint Committee of Cancer. Stages of Lung Cancer according to TNM system is:
Stage 0: It is also called carcinoma in situ and the cancer cells is found only in the lining of the lungs. Carcinoma in situ depicts that carcinoma has not spread to the nearby tissue or lymph nodes.
Stage I: It means that cancer is only found in the lungs and has not spread to nearby lymph nodes or other part of the body
Stage II: It means that cancer has spread to nearby lymph nodes or tissues like diaphragm etc.
Stage III: It means that cancer has spread to lymph nodes in the chest or to nearby tissues like heart or esophagus.
Stage IV: It is means that cancer has spread to other parts of the body or distant organs like brain, bone, liver etc.
The stages of lung cancer are further subdivided into based on the size and location of the tumor, and number of lymph nodes involved or affected. Determining stage of the lung cancer is one of the important factor so as to decide over available appropriate treatment options and predicting outcome of the lung cancer. Staging of the lung cancer should be done meticulously as it help in further treatment related discourse of the patient, and affects overall survival and progression free survival of the patient.
Lung Cancer Metastasis
Metastatis of the lung cancer refers to the spread of the cancer from the lungs to other parts of the body. Lung cancer metastatis can affect various organs such as bones, liver, brain, lymph nodes etc.
The most common sites metastasis of lung cancer are:
- Liver: Lung cancer can spread to liver through blood or the lymphatic system. Symptoms of metastatis to the lung cancer are loss of appetite, jaundice, abdominal pain etc.
- Bones: Lung cancer can metastasize to the bones further causing pain and fractures at the site of affected bone.
- Brain: Lung cancer can also metastasize to the brain causing symptoms of seizure, headache, paralysis, loss of vision etc.
Mostly for metastatis of the lung cancer an approach of palliative care is generally taken which involves different modalities to help to manage symptoms, and most important of all to improve the quality of life of the patients.
Early detection and prompt treatment of the metastatis of lung cancer is most important as it improved the chances of treatment and helps in prolonging the survival.
Lung Cancer Treatment
Lung Cancer requires extensive treatment, very nuanced approach and precise medical attention. Treatment of lung cancer widely depends on the stage of the cancer , tissue effected , metastasis and general health of the patient. Some common treatment options of the lung cancer are:
- Surgical excision
- Radiation therapy
- Chemotherapy
- Targeted therapy
- Immunotherapy
It is important to note that every case of lung cancer is unique and will require meticulous treatment planning and implementation. Prognosis largely depends upon individual factors some cases responding greatly to a given treatment plan while some do not. So a dynamic treatment plan is necessity of the time for a greater benefit of the patient.
About Ayurveda
Ayurveda is a traditional system of Indian Medicine which has originated in India approximately around 5000 years ago. Ayurveda propagates and promotes the one of the most basic principles that overall health and wellness of an individual depends on a delicate balance between mind, body and spirit. As per Ayurveda, the universe is composed of five basic elements (panchamahabhutas) – Aakash (Space), Vayu (Air), Agni (Fire), Jala (Water) and Prithvi (Earth). These basic elements of universe or panchamahabhutas combine to form three different type of doshas or governing energies in an individual – Vata (Aakash + Vayu), Pitta (Agni + Jala) and Kapha (Jala + Prithvi). This three doshas governs all the physical and mental functions in an individual.
Ayurvedic medicine helps to restore, and maintain the delicate balance, and the harmony between the body and mind using centuries of time tested and proven holistic approaches which includes herbal remedies or drugs, lifestyle modifications, and other natural therapies like Panchakarma.
As per Ayurveda, every patient is unique in its composition of doshas so are the rogas or diseases which are caused by doshas. So, Ayurveda system of medicine has individualized and tailored approach of treatment of a disease like cancer, and it also addresses the root cause of cancer which has caused it in first place while treating the cancer also. Ayurveda teaches that not two lung cancer cases are same in composition of doshas and should be treated or approached as unique patients.
Lung Cancer in Ayurveda / फेफड़ा या फुप्फुस का अर्बुद या कैंसर
Lung Cancer is definitely mentioned in Ayurvedic Texts but in concise form because of well-known theory of Ayurveda that the diseases which is in low incidence in the respective era is to be mentioned in brief due to concern of Grantha Vistar (increase in the size of texts) and incidentally as in the following era if the incidence of disease increases the texts can be increased by vaidyas on their vivek buddhi (doctors wisdom).
It is well known and noted fact that incidence of lung cancer has risen exponentially post industrialization due rapid increase in exposure to different types of carcinogens, and increase in unhealthy lifestyle like smoking tobacco and junk diets. So the incidence of lung cancer in pre-industrialization era which was more of hereditary lung cancer type and less of acquired lung cancer has changed post-industrialization due to exponential increase in acquired lung cancer case and eventually resulting in increase in overall incidence of cancer.
As we go through our Ayurvedic texts, and evaluate its references we can definitely find out that Kshataja and Kshayaja types of Cough/Kasa (क्षतज और क्षयज कास) as mentioned in ayurveda can be theoretically and practically correlated on the basis of the symptoms with modern day terminology as ‘Lung Cancer’. Kshataja and Kshayaja Cough (क्षतज और क्षयज कास) is mentioned in chapter 18 of Charak Samhita Chikitsasthana.
Let’s have a look at causative factors and symptoms of Kshataja and Kshayaja Kasa (क्षतज और क्षयज कास) –
अतिव्यवायभाराध्वयुद्धाश्वगजविग्रहैः | रूक्षस्योरः क्षतं वायुर्गृहीत्वा कासमावहेत् ||२०|| स पूर्वं कासते शुष्कं ततः ष्ठीवेत् सशोणितम् | कण्ठेन रुजताऽत्यर्थं विरुग्णेनेव चोरसा ||२१|| Charak Chikitshasthana 18
सूचीभिरिव तीक्ष्णाभिस्तुद्यमानेन शूलिना | दुःखस्पर्शेन शूलेन भेदपीडाभितापिना ||२२|| पर्वभेदज्वरश्वासतृष्णावैस्वर्यपीडितः | पारावत इवाकूजन् कासवेगात्क्षतोद्भवात् ||२३|| Charak Chikitshasthana 18
Signs and symptoms of Kshatja Kasa (क्षतज कास) are excessive cough with blood-tinged sputum, severe and excruciating pain in chest, humming of pigeon like sound while coughing, sensation of pricking like pain in the chest etc.
विषमासात्म्यभोज्यातिव्यवायाद्वेगनिग्रहात् | घृणिनां शोचतां नॄणां व्यापन्नेऽग्नौ त्रयो मलाः ||२४|| कुपिताः क्षयजं कासं कुर्युर्देहक्षयप्रदम् | दुर्गन्धं हरितं रक्तं ष्ठीवेत् पूयोपमं कफम् ||२५|| Charak Chikitshasthana 18
Kshayaja Kasa is caused by consuming vishamashana and asatmya ahara (unhealthy and harmful foods), indulging in excessive sexual activity, holding natural calls for long time like urge to urination, passing stools etc. All the mentioned factors further affect the Agni and thereby leads to the aggravation of the doshas causing Kshayaja Kasa.
दुर्गन्धं हरितं रक्तं ष्ठीवेत् पूयोपमं कफम् ||२५|| स्थानादुत्कासमानश्च हृदयं मन्यते च्युतम् | अकस्मादुष्णशीतार्तो बह्वाशी दुर्बलः कृशः ||२६|| स्निग्धाच्छमुखवर्णत्वक् श्रीमद्दर्शनलोचनः | पाणिपादतलैः श्लक्ष्णैः सततासूयको घृणी ||२७|| ज्वरो मिश्राकृतिस्तस्य पार्श्वरुक् पीनसोऽरुचिः | भिन्नसंहतवर्चस्त्वं स्वरभेदोऽनिमित्ततः ||२८|| इत्येष क्षयजः कासः क्षीणानां देहनाशनः | साध्यो बलवतां वा स्याद्याप्यस्त्वेवं क्षतोत्थितः ||२९|| नवौ कदाचित् सिध्येतामेतौ पादगुणान्वितौ | स्थविराणां जराकासः सर्वो याप्यः प्रकीर्तितः ||३०|| Charak Chikitshasthana 18
Signs and symptoms of Kshayaja Kasa (क्षयज कास)) are coughing of sputum which can be greenish, reddish, purulent and foul smelling in nature, felling of weakness, loss of weight, fever, anorexia, change in voice, mentally he will always find fault in different things, felling of hot and cold sensation etc.
Treatment of Lung Cancer in Ayurveda / फेफड़ा या फुप्फुस का अर्बुद या कैंसर
Ayurveda is many centuries old indigenous system of Indian medicine and is well known since ancient days in preventing or suppressing various neoplasm or tumours. Although nowadays modern scientists and researcher seems keener to know more about Ayurveda and its way of living but wisdom of the Ayurveda remains the same.
The main goal of Ayurveda Science is to find the cause of the Cancer and prevent it from originating while the therapeutic approach of Ayurveda in Cancer is divided into three major categories: –
- A) Oral medications.
- B) Panchakarma and its allied different karmas.
- C) Pranayama
Oral Medications
In Ayurveda there are multiple formulations containing herbal as well as herbo metallic drugs mentioned in texts which help in treating or even curing the Lung Cancer depending on the stage of the Lung Cancer. Below we will discuss few such formulations which is beneficial in Lung Cancer.
- Pippali (Piper Longum) or Long Pepper in Lung Cancer
Piper Longum which is known as long pepper in common language today is also called as Pippali or Magadhi in Ayurveda. Pippali or Piper Longum is native plant to India but is also found worldwide including other parts of the worlds like Asia, Africa and some of the Pacific Worlds. The fruit of Piper Longum or Long Pepper is sun dried and powdered, and is used in further ayurvedic medicine formulations and culinary purposes.
Modern research has found that certain compounds in Piper Longum such as piperlongumine have anti-cancer properties. Piper longumine induces cell deaths or apoptosis in many cancer cells like breast, prostate, lung and colon cancer cells. It initiates apoptosis thereby helping in death of cancer cells by targeting the metabolism and inhibiting it growth further.
Many different formulations of Pippali (Piper Longum) are mentioned in Ayurveda which can be successfully used in lung cancer patients, and one such formulation is Chausath Prahari Pippali Rasayan (चौसठ प्रहरी पीपल रसायन).
Chausath Prahari Pippali Rasayan (चौसठ प्रहरी पीपल रसायन) in Lung Cancer Patients
Chausath Prahari Pippali Rasayan is prepared by titrating (doing mardana karma) of small (choti) pippali powder with big (badi) pippali phanta or hot infusion for 192 hours (1 prahar = 3 hours, so 64 parhar is 192 hours). Chausath Prahari Pippali Rasayan works efficiently in respiratory disease, gastrointestinal disorders, fever, liver disorders and constipation. This formulation of pippali (Piper Longum) is further fortified by the process of titration (doing mardana karma).
- Kantakari (Solanum Xantocarpum) in Lung Cancer
Solanum xantocarpum or Kantakari in Ayurveda is also known as Yellow berried nightshade belongs to Solanaceae family. Kantakari is a native plant to India and is widely distributed across Asia. In Ayurveda, roots, leaves and fruits of Kantakari (Solanum Xantocarpum) are used to treat various ailments like fever, gastro-intestinal disorders, respiratory disorders etc. Kantakari or Solanum xantocarpum displays properties of antioxidant, anti-cancer, analgesic etc.
Modern research has found that Kantakari or Solanum xantocarpum has anti-cancer properties. It has been found that Kantakari or Solanum xantocarpum inhibits cancer cells growth by arresting cell cycle growth and inducing apoptosis or programmed cell death. It has also been proven that Kantakari or Solanum xantocarpum possess anti-oxidant properties, and so reduces oxidative stress and inflammation further reducing the risk of Cancer.
Many different formulations of Kantakari (Solanum xantocarpum) are mentioned in Ayurveda which can be successfully used in lung cancer patients, and one such formulation is Kantakari Avaleha.
Kantakari Avaleha (कंटकारी अवलेह) in Lung Cancer
Kantakari Avaleha (कंटकारी अवलेह) is an ayurvedic herbal jam which prepared by taking different ayurvedic medical herbal plants like Kantakari, Guduchi (Tinospora cordifolia), Chitrak (Plumbago zeylenica) etc, and a decoction is prepared of the same. Later sugar, ghee and sesame oil is added in the same. When a semi solid consistency is achieved fire flame is switched off and few more herbs is added, and Kantakari Avaleha (कंटकारी अवलेह) or Ayurvedic Herbal Jam is ready.
Kantakari Avaleha (कंटकारी अवलेह) works widely in respiratory condition like Lung Cancer, cough, cold and allergic bronchitis condition.
- Abhrak Bhasma (Mica) in Lung Cancer
Abhrak Bhasma is an Ayurvedic Medicine which is prepared from abhrak or mica as mentioned in Ayurveda. Abhrak Bhasma has multiple therapeutic properties and is used in various ailments. It is also used to maintain general health of an individual.
The method of preparation of Abhrak Bhasma involves purification of the mineral with different ayurvedic herbs and many other ingredients, and further involves grinding the mineral into fine powder making it suitable for further processing. Last procedure involves subjecting the mineral to high temperatures thereby enhancing it properties and making it suitable for human consumption. Two different formulations are available: 1) Shatputi Abhrak Bhasma 2) Shastraputi Abhrak Bhasma.
Abhrak Bhasma is prescribed into multiple disorders pertaining to respiratory conditions, gastro-intestinal disorders, dermatological conditions, and most important in neurological conditions. Abhrak Bhasma has a good anti-aging and rejuvenating properties. Modern research has revealed antiproliferative activity in lung cancer of Abhrak Bhasma in vitro.
Panchakarma
Panchakarma is composed two words so called 1) Pancha – Five and 2) Karma – Actions. Accordingly, Panchakarma essentially means 5 karmas or actions that is used to detoxify or to do shuddhikaran of the body. It includes Vaman, Virechan, Basti, Raktamokshan, and Nasya. However some other procedures are also involved in the list of Panchakarma and the list can beyond five.
- Vaman
If Lung Cancer is detected early stage then as per modern treatment resection of the nodule by surgery is best treatment. If resection of the nodule is not possible because of some unavoidable anatomical locations or rest other co-morbidities like existing Heart disease subsequently a Radiotherapy or Chemotherapy is planned. Prior to this Radiotherapy or Chemotherapy treatment a Vaman Karma should be planned first so the patient will respond better to Chemotherapy or Radiotherapy better.
- Virechan
After the cancer nodule has been resected, and the Chemotherapy and Radiotherapy is administered after Vaman Karma, and if the patient is declared to be in remission. Afterwards that we advise Vardhaman Pippali Rasayan or Chausath Pippali Rasayan Therapy according to Ayurvedic Principles to prevent relapse of the Cancer. So prior to Rasayan Therapy Kostha Sudhi is important for Agnideepan and proper absorption of Rasayan Dravyas, so Virechan Therapy can be given before advising Rasayan Therapy so as to prevent relapse of the Cancer.
- Nasya
Nasya can be successfully used in cases of Lung Cancer, and even Head and Neck Cancer too. Nasya is procedure of instilling ayurvedic medicated oils or juices extracted from the plants in to nostrils. Nasya is prominently used urdhava jatrugata vikara or region of the body above clavicle, and it involves lungs too. For lung cancer nasya of Kshar Tel or Rasanjan Oil can be successfully used.
Pranayama
Pranayama is one of the most important aspect of Yoga, and it involves practice of controlled breathing techniques. Pranayama enhances physical, mental and spiritual well-being of a person through regulation of breath and consciousness.
The several different types of pranayama mentioned in yoga are – 1) Nadi Shodhana Pranayama (Alternate Nostril Breathing). 2) Kapalabhati Pranayama (Skull Shining Breath). 3) Bhramari Pranayama (Bee Breath). 4) Ujjayi Pranayama (Victorious Breath). Pranayama can help to improve health, reduce stress, and promotes overall mental well-being of a person.
About Team ‘Cancer in Ayurveda’
Our Team ‘Cancer In Ayurveda’ consists of Ayurvedic practitioners who are dedicated to providing patients with the best possible care for cancer. We at Team ‘Cancer In Ayurveda’ believe that Ayurveda can complement modern medicine and provide patients with a more comprehensive approach to their care. Our personalized approach to treatment, extensive knowledge of Ayurvedic herbs, use of Panchakarma, and modern parameters make us one of the most dynamic teams of Ayurvedic cancer experts in Mumbai.
We at Team ‘Cancer In Ayurveda’ are committed to helping patients manage their condition effectively and provide them with the support and guidance they need throughout the process.
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