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Pain Management
Despite tremendous progress in medicine during last couple of decades, cancer still remains the most horrifying diagnosis for anybody due to its almost inevitable futility. Most fearsome symptom regardless of cancer type for a cancer patient is and always will be the pain. According to statistics published by the American Cancer Society in 2002, “50%–70% of people with cancer experience some degree of pain” (ACS 2002), which usually only intensifies as the disease progresses. Less than half get adequate relief of their pain, which negatively impacts their quality of life. The incidence of pain in advanced stages of invasive cancer approaches 80% and it is 90% in patients with metastases to osseous structures (Pharo and Zhou 2005). Different oral treatment like Vijaya formulations and Panchakarma , procedures mentioned in Ayurveda can help to reduce the pain symptoms of the patients.‘Pain Management’ in Cancer Patients as per Ayurveda
Pain Management
1) Nerve Pain in Cancer Patients
a) Direct Nerve Compression: Pain can result from infiltration or compression of nerve from tumor or cancer thereby causing pain.
b) Chemotherapy-Induced Peripheral Neuropathy (CIPN): It is well known fact that certain chemotherapeutic drugs that damage the nerve, and causes symptoms like tingling, numbness, shooting pain and burning sensation in the limbs.
d) Post-Surgical Neuropathy: Different surgical procedure for cancer can damage the nerve, and thereby leading chronic neuropathic pain in the operated site.
e) Paraneoplastic Neuropathies: Cancer can trigger autoimmune response, and further lead to neuropathic pain.
2) Bone Pain in Cancer Patients
Pain due to cancer in the bone is of the common complain of cancer patients, and it quite distressing too. Pain in the bone due to cancer typically occurs when cancer has metastasized (deposited) to the bone from cancer originating in another part of the body or when the cancer has originated in the bone itself. Further is some description about bone pain in cancer patients:
b) Primary Bone Pain: Sometime cancer can originate in the bone itself such as Osteosarcoma or Ewing’s Sarcoma. In such cases, bone pain is typically primary and early complain.
d) Severity of Pain: Bone pain due to primary or secondary can cause mild discomfort, and or even debilitating and distressing pain. Bone pain in cancer patients can interfere with their daily activities, and can even degrade their quality of life.
3) Soft Tissue Pain in Cancer Patients
a) Direct Tumor Invasion: Pain in soft tissue of cancer patients can be due to direct invasion of the cancer in adjacent tissues or compression of the adjacent tissue
b) Side Effects of Treatment: Different treatment modalities like surgery, radiation therapy, chemotherapy, and immunotherapy can cause soft tissue pain in cancer patients.
c) Neuropathy: Some chemotherapeutic drugs damages the nerve and further causes peripheral neuropathy. Peripheral neuropathy causes pain, tingling and numbness in the soft tissues.
c) Neuropathy: Some chemotherapeutic drugs damages the nerve and further causes peripheral neuropathy. Peripheral neuropathy causes pain, tingling and numbness in the soft tissues.
d) Muscle Weakness: Muscle wasting due to cancer, and cancer or its treatment related fatigue can cause soft tissue pain.
4) Phantom Pain in Cancer Patients
a) Nerve Pain: Damage to the nerves happens during surgery for removal of tumors or organs. These damage to the nerve can lead to abnormal signaling, and it can further lead to perception of pain in that area which has been excised.
b) Neuropathic Pain: Phantom pain in cancer patients can also be designated as neuropathic pain, and it can be give rise to abnormal sensation characterized by burning, or stabbing kind of pain.
c) Central Nervous System Involvement: In phantom pain Peripheral Nervous System (PNS) are not only solely responsible but Central Nervous System (CNS) also plays an important role. Central Nervous System (CNS) facilitates in generating and amplifying the pain.
5) Referred Pain in Cancer Patients
Referred pain in cancer patients is described by experience of pain away from the actual tumor site in the patients suffering from the cancer. Referred pain are actually confusing and challenging as then source of the pain is away from the actual of the cause of the pain. Referred pain are due to complex interaction between nervous system and the cancer within the body. Let’s describe referred pain in cancer patients further.
1) Mechanism: Referred pain in cancer patients occurs primarily due to same neural pathways that carries the pain signal from the tumor site innervate other areas of the body. Referred pain can also be due to wrongful interpretation of the pain from different location when the nerve from actual tumor site is surrounded by inflammation
2) Diagnosis: Diagnosis of the causative factor of pain in cancer patients is quite challenging and distressing as the actual site of the cancer is different from the site of the pain. Different diagnostic modalities like CT scans, MRI, and PET scan, can help to identify the cancer, and it actual size.
Management of Nerve Pain Management’ in Cancer Patients as per Ayurveda
There are many different treatment modalities mentioned in Ayurveda that will immensely benefit cancer patients suffering from nerve pain due to cancer. Such treatment modalities are mentioned further:
a) Mahavat Vidhwansan Ras (महावातविध्वंसन रस) for Nerve Pain in Cancer Patients
“Mahavat Vidhwansan Rasa” is an Ayurvedic medicine formulation in tablet form, and is a traditional Ayurvedic medicine used in the management of various neurological and musculoskeletal disorders. It is mentioned in Kharaliya Rasayanadhyaya of Rasashastra Siddha Prayoga Sangraha.
The main ingredients of Mahavat Vidhwansan Rasa are Shuddha Mercury (Parada), Shuddha Sulphur (Gandhaka), Naga Bhasma, Vanga Bhasma, Copper (Tamra) Bhasma, Lauha (Iron) Bhasma, Abhraka (Mica) Bhasma, Sohaga (Tankan) Bhasma, Pippali (Pipper Longum) Powder, Maricha Powder, and Sunthu (Dry Ginger) Powder each is taken one part, and Suddha Vastanabha (Aconitum Ferox) powder is taken in four parts. This powder is titrated or bhavana is given decoction or juice of Trikatu Kwath, Trifala Kwath, Chitraka Mula Kwath etc, are given 3 times each. The mixture is dried and tablet is prepared of 125mg or 1 ratti. Mahavat Vidhwansan Rasa can be taken with ginger juice, bhringaraja juice (Eclipta Alba juice), Castor Oil etc.
Mahavat Vidhwansan Rasa is beneficial in many conditions like neuralgia, neuropathy, neuritis, neurological conditions, sciatica etc. It also proves extremely beneficial in nerve pain in cancer patients.
b) Ekangavir Ras (एकांगवीर रस) for Nerve Pain in Cancer Patients
Ekangavir Ras is a traditional Ayurvedic medicine, and is primarily neuro-muscular diseases. Ekangavir Ras is prepared in tablet form and can prove extremely beneficial in nerve pain of cancer patients.
The main ingredients of Ekangavir Ras is Shuddha Parada, Abhraka (Mica) Bhasma, Thiksana Lauha (Iron) Bhasma, Kanta Lauha (Iron) Bhasma, Shuddha Gandhaka, Vanga Bhasma, Naga Bhasma, Tamra (Copper) Bhasma, Sunthi (Dried Powder), Maricha Powder and Pippali Powder. This mixture is further is titrated or bhavna is given with Trifala Kadha, Nirgundi Juice, Trikatu Kadha, Bhringaraja Juice etc. It is dried and tablet is prepeared of 125 mg or 1 ratti, and 1 to 2 tablets are taken twice a day.
Ekangavir Ras proves beneficial in neuro-muscular disorders like paralysis, hemiplegia, facial palsy etc., and other associated disorders. Ekangavir Ras helps to maintain strength of the nerves, and prevent muscle loss. It improves the functioning of the nerves, and proves beneficial in paralytic conditions.
Management of ‘Bone Pain in Cancer Patients’ according to Ayurveda
There are many different treatment modalities mentioned in Ayurveda that will immensely benefit cancer patients suffering from bone pain due to cancer. Such treatment modalities are mentioned further:
a) Suvarna Malini Vasant (स्वर्ण वसंत मालती) for bone pain in Cancer Patients
Suvarna Malini Vasant is traditional ayurvedic medicine that is available in tablet form. It is used in Rajayakshma (Tuberculosis), and strengthen immune system of cancer patients. The components of Suvarna Vasant Malini are Suvarna Bhasma, Mouktik Bhasma, Shuddha Hingul, Maricha Powder, and Jasad Bhasma. The mixture is titrated or bhvana is given cow butter, and later with lime juice (nimboo rasa). After the mixture is dried and a tablet is prepared of 125 mg or 1 ratti. One tablet once a day or twice a day can be consumed.
Suvarna Malini Vasant proves beneficial in treatment of arthritis, and bone pain due to multiple disorders. It is also beneficial as general tonic, liver tonic and nervine tonic. Suvarna Malini Vasant is cardio-stimulant, aphrodisiac, and detoxifies the body. Suvarna Malini Vasant is a good anti-infective drug, and has anti-aging or rejuvenating properties.
Suvarna Malini Vasant also proves beneficial in hyperacidity, lack of sleep, oral and gastric ulcers, and migraine. It is help to reduce recurrent illness so can prove extremely beneficial in cancer patients. It is also beneficial in debilitating conditions like cancer.
b) Panchatikta Ghrita Guggul (पंचतिक्त घृत गुग्गुल) for bone pain in Cancer Patients
Panchatikta Ghrita Guggul is a multiherbal preparation of Ghrita as mentioned in traditional ayurvedic texts in tablet form, and is often indicated in Asthimajjagata Vata. Panchatikta Ghrita Guggul overall rasa is Tikta Rasa, Usna Virya, and is of Madhur and Katu Vipaka.
The major ingredients of of Panchatikta Ghrita Guggul is Nimba, Guduchi, Vasa, Patola, Kantakari, Patha, Vidanga, Devdaru, Gajapippali, Yavakshara, Svarjikakshara, Sunthi, Haridra, Mishi, Chavya, Kushtha, Vacha, Yavani, Shuddha Bhallataka, Shuddha Guggul, and Shuddha Goghrita. Panchatikta Ghrita Guggul promotes dhatvagni through its Deepana – Pachana action, and promotes nutrition in Saptadhatus especially Asthi and Majja Dhatu. Through it action on asthi-majja dhatu, Panchatikta Ghrita Guggul proves beneficial in bone pain due to cancer.
Panchatikta Ghrita Guggul is ameliorate vatapitta, reduces fever, increases vitality, and overall age of the cancer patients. Panchatikta Ghrita Guggul ameliorate vata dhatu especially in asthi and majja dhatu, and improves quality of asthi and majja dhatu thereby benefiting cancer patient who are suffering from bone pain due to primary or secondary cancer.
Management of ‘Soft Tissue Pain in Cancer Patients’ according to Ayurveda
There are many different treatment modalities mentioned in Ayurveda that will immensely benefit cancer patients suffering from soft tissue pain due to cancer. Such treatment modalities are mentioned further:
a) Triphala Guggulu (त्रिफला गुग्गुल) for soft tissue pain in Cancer Patients
Triphala Guggul is one of the most important and widely used formulation as mentioned in Ayurveda, and is frequently used in inflammatory, and its associated edematous disorders. Triphala Guggul is a traditional Ayurvedic formula, and is prepared in tablet or vati form.
The main ingredients of Trifala Guggul is Amlaki (Phyllanthus emblica), Haritaki (Terminalia chebula), Vibhitaki (Terminalia bellirica), Pippali (Piper longum), and extract of Guggul (Commiphora wightii). This mixture is titrated with triphala decoction and tablet is prepared of 250 mg, and one to two tablets can be administered twice a day. Triphala Guggul is of Madhura, Tikta, and Kashay Rasa, Ushna Virya, and Katu Vipaka
Triphala Guggul is an immuno-modulatory, anti-inflammatory, anti-oxidant, anti-microbial, anti-pyretic, analgesic activity, and hepato-protective in activity. Triphala Guggul also exhibits cytotoxic or anti-cancer activity, so it proves beneficial soft tissue pain due to cancer.
b) Shothari Lauh (शोथारी लौह) for soft tissue pain in Cancer Patients
Shothari Lauh is one of the most important and widely used formulation as mentioned in Ayurveda, and is frequently used in inflammatory, and its associated disorders in which swelling is prominent. Shothari Lauh is a traditional Ayurvedic formula, and is prepared in tablet or vati form.
The main ingredients of Shothari Lauh is Lauh Bhasma, Shunthi (Dry Ginger), Maricha (Piper nigrum), and Pippali (Piper longum). This mixture is taken together and tablets is prepared of 250 – 500 mg. In inflammatory conditions, one to two tablets can be taken twice a day.
Shothari Lauh is anti-inflammatory in nature, hepatoprotective, anti-microbial, maintains cardio-vascular health, hypo-lipidaemic, anti-pyretic etc. Shothari Lauh (शोथारी लौह) proves beneficial in soft tissue pain in Cancer Patients.
Management of ‘Referred Pain in Cancer Patients’ according to Ayurveda
There are many different treatment modalities mentioned in Ayurveda that will immensely benefit cancer patients suffering from referred pain due to cancer. Such treatment modalities are mentioned further:
a) Sameerpannag Rasa (समीरपन्नग रस) for referred pain in Cancer Patients
Sameer Pannag Rasa is a Kupipakwa Rasayana, and is one of the most popular, unique, and important formulation mentioned in Ayurveda. Kupipakwa Rasayana in mentioned in Ayurveda, and is used in small dose, and has properties of rapid action.
The main ingredients of Sameer Pannag Rasa is Parada (Mercury), Gandhaka (Sulphur), Somala (Arsenic Trioxide), Manashila (Arsenic disulphide), and Hartala (Arsenic trisulphide). First of all Shuddha Parada and Shuddha Gandhaka is mixed together is Kharala, and Kajjali is prepared. Following Kajjali preparation, Shuddha Hartala, Shuddha Manashila, and Shuddha Somala is added. This mixture is further titrated with Tulsi Patra Swarasa. Further Sameer Pannaga is prepared according to Kupipakwa method.
Sameer Pannag Rasa has properties of katu rasa, katu vipaka, usna virya. tikshna virya, uttejaka, balya, and kaphagna. Sameer Pannag Rasa proves beneficial in hemiplegia, paralysis, sciatica, Bell’s Palsy, Tetanus, and many other nervous system related disorder. Sameer Pannag Rasa also proves beneficial in asthama, bronchitis, and other vatakaphaj disorders.
About Team ‘Cancer In Ayurveda’
Team ‘Cancer In Ayurveda’ takes a holistic approach to health and disease, emphasizing the balance of mind, body, and spirit. Team ‘Cancer In Ayurveda’ believe that imbalances in the body’s doshas (Vata, Pitta, and Kapha) can contribute to the development of cancer. Team ‘Cancer In Ayurveda’ believes that Ayurveda aims to restore this balance and promote overall well-being.
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