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Cancer Wound Management in Ayurveda
Wound Management plays a critical role in addressing non-healing wounds or ulcers associated with cancer, whether they arise as complications of the disease itself or as a result of cancer treatments. Malignant cancers can disrupt skin tissue, compromise blood circulation, and suppress the immune system, contributing to the development of wounds in affected areas.
Cancerous wound occurs due to increased necrosis and infection around the cancer site, and fungating wounds may affect up to 5% of patients in advanced stages of cancer. The estimated life expectancy or overall survival in cancer patients at advanced stage who has developed fungating wounds is about 6 to 12 months.
Commonest site of cancer wounds
The most common site of cancerous wounds can vary depending on the type of the cancer the patient is suffering from. Some of the common sites cancerous wounds are:
5) Cancerous wound due to Mouth and Throat Cancer: Mouth and Throat Cancer can lead to cancerous wounds in the mouth or throat. Mouth and throat cancer is often associated with or increased risk with tobacco and alcohol consumption.’
6) Cancerous wound due to Cervical Cancer: Cervical cancer present as abnormal or malignant lesions on the cervix. Cervical cancer can be detected through PAP smears.
Reference of ‘Cancerous wounds’ in Ayurveda
In Ayurveda, cancerous wound or fulminant cancer can be defined as ‘Raktha-Arbuda’. In current era, ‘Raktha-Arbuda’ is thought to be called any type of blood cancer but in real theoretical and practical terms it is called ‘Cancerous wound or Fulminant Cancer’.
रक्तार्बुद
दोष: प्रदुष्टो रुधिरं सिरास्तु सम्पीड्य सन्कोच्य गतस्वपाकम् ॥ सास्रावमुन्नह्यति मांसपिण्डं मांसाड्ंकुरैरचितमाशुवृद्धिम्। स्रवत्यजस्रं रुधिरं प्रदुष्टमसधिरात्मकं स्यात॥ रक्तक्षयोपद्रपीडितत्वात् पाण्डुर्भवेत सोऽर्बुदपीडितस्तु। सु.नि 11/15-16 ’.
प्रदुष्ट दोष रक्त और सिरा को पीडित तथा संकुचित कर पाक को प्राप्त नहीं होते हैं जिससे स्रावयुक्त मांसपिण्ड को ’उन्नह्यति’ अर्थात उभार युक्त कर देते हैं।
इससे दूषित रुधिर निरन्तर स्रवित होता रहता है। यह रक्तार्बुद असाध्य है। रक्तार्बुद से पीडित व्यक्ति रुधिर के निकल जाने से उपद्रव – पीडित होकर पाण्डु वर्ण का हो जाता है॥
In short Raktha-arbuda mostly closely represent an ulcerating raised wound consisting of granulating tissues with continuous bloody discharge and the same is called Asadhya Vyadhi.
Concept of ‘Vrana’ or ‘Wound’ in Ayurveda
निजः शरीर दोषोत्थ आगन्तुर्बाह्यहेतुजः ||६|| वधबन्धप्रपतनाद्दंष्ट्रादन्तनखक्षतात् | आगन्तवो व्रणास्तद्वद्विषस्पर्शाग्निशस्त्रजाः ||७|| मन्त्रागदप्रलेपाद्यैर्भेषजैर्हेतुभिश्च ते | लिङ्गैकदेशैर्निर्दिष्टा विपरीता निजैर्व्रणैः [२] Charak Chikitsasthana 25/8
There are two types of ‘Vrana or Wounds or Ulcers‘ as mentioned in Ayurveda: 1) Endogenous Wounds (Nija Vrana). 2) Exogenous Wounds (Bahya Vrana). Endogenous wounds is caused due to factors evolving internally in the body due to vitiated doshas.
Cancerous wounds or non-healing cancerous ulcers can be classified as Endogenous Wounds (Nija Vrana). Exogenous Wounds or ulcers are caused due to external injuries by falling down, bite from teeth, nails and fangs, and or due to contact of poisonous substance. Exogenous wounds or ulcers can also be caused due to fire or due to injuries from a weapon.
Twenty types of Ulcers or Wounds mentioned in Ayurveda, and the same principle can be applied over non-healing cancer wounds or ulcers
कृत्योत्कृत्यस्तथा [१] दुष्टोऽदुष्टो मर्मस्थितो न च |संवृतो दारुणः स्रावी सविषो विषमस्थितः ||२०||उत्सङ्ग्युत्सन्न एषां च व्रणान् विद्याद्विपर्ययात् |इति नानात्वभेदेन निरुक्ता [२] विंशतिर्व्रणाः ||२१|| Charak Chikitsasthan 25
Twenty types of wounds as described in Ayurveda are, curable wounds (treatable by surgical modality), incurable (untreatable) wounds, infected wounds, non-infected wounds, wounds originating in the vital parts or marma sthana, wounds not originating in the vital parts or marma stana, closed wounds, open wounds, hard wounds, soft wounds, discharging wounds, non-discharging wounds, poisonous wounds, non-poisonous wounds, even wounds, uneven wounds, pouched wounds, unpouched wounds, elevated wounds, and depressed wounds.
These twenty types of wounds or ulcers varies, and has multiple distinguishing features. Cancerous wounds or Non-Healing Ulcers can have multiple features mentioned above under the category of twenty different types of wounds mentioned in Ayurveda.
Causes of non-healing ulcers or wounds, and the same principle can be applied over non-healing cancer wounds or ulcers
स्नायु क्लेदात्सिरा क्लेदाद्गाम्भीर्यात्कृमि भक्षणात् ||३१||अस्थि भेदात् सशल्यत्वात् सविषत्वाच्च सर्पणात् |नख काष्ठ प्रभेदाच्च चर्म लोमातिघट्टनात् ||३२|| मिथ्या बन्धादति स्नेहादतिभैषज्यकर्षणात् |अजीर्णादतिभुक्ताच्च विरुद्धासात्म्यभोजनात् ||३३||शोकात् क्रोधाद्दिवास्वप्नाद्व्यायामान्मैथुनात्तथा |व्रणा न प्रशमं यान्ति निष्क्रियत्वाच्च देहिनाम् ||३४||परिस्रावाच्च गन्धाच्च दोषाच्चोपद्रवैः सह |व्रणानां बहुदोषाणां कृच्छ्रत्वं चोपजायते ||३५|| Charak Chikitsasthan 25
The causes of non-healing ulcers or wounds according is enumerated into twenty four etiological factors, and it as follows: 1) increase of abnormal fluid content in ligament. 2) Excess abnormal fluid in veins. 3) Deep wounds. 4) Wounds infested by maggots. 5) Wounds originating from bones. 6) Wounds due to presence of foreign bodies. 7) Wounds due to presence of toxins or poisons. 8) Wounds that is spreading. 9) Wounds that is caused due to nails or wooden objects. 10) Wounds that is caused due to friction between skins. 11) Wounds that is caused due to frictions of body hair. 12) Wounds that is caused application of bandage in wrong method. 13) Wounds that is caused due to application excessive unctuous medications. 14) Wounds that is caused due to excessive irritating medicines. 15) Patients suffering from indigestion. 16) Patients who are overeating. 17) Patients who are consuming incompatible foods. 18) Patients who are consuming unsuitable foods. 19) Patients who are depressed. 20) Patients who are angry a lot. 21) Patients who sleep during day time. 22) Patients who are involved into physical exercise. 23) Patients who are involved into excessive sexual intercourse. 24) Patients who are physically less active.
Wounds that is affected by excessive vitiated doshas, excessive discharge, excessive and foul smelling odors, excessive defects, and excessive complications.
Factors that affects the prognosis of non-healing wounds or ulcers, and the same principle can be applied over non-healing cancer wound or ulcers
त्वङ्मांसजः सुखे देशे तरुणस्यानुपद्रवः |धीमतोऽभिनवः काले सुखसाध्यः स्मृतो व्रणः||३६||गुणैरन्यतमैर्हीनस्ततः कृच्छ्रो व्रणः स्मृतः|सर्वैर्विहीनो विज्ञेयस्त्वसाध्यो निरुपक्रमः||३७|| Charaka Chikitsasthan 25
Factors influencing the curability of wounds are if the wound is located in the layers of skin and muscles, if the wound is at easily accessible and easy places, if the cancer patient if of youthful age, and the wound is without complication and of recent origin.
If the wound is devoid of some of the above mentioned properties, then the wound can be treated with difficulty and if the wound is devoid all the above mentioned properties it is incurable, and thus accordingly to Acharya Charaka should not be treated.
Principles applied in management of non-healing wounds or ulcers, and the same principle can be applied over non-healing cancer wound or ulcers
व्रणानामादितः कार्यं यथासन्नं विशोधनम् |ऊर्ध्वभागैरधोभागैः शस्त्रैर्बस्तिभिरेव च ||३८||सद्यः शुद्धशरीराणां प्रशमं यान्ति हि व्रणाः |३९| Charaka Chikitsasthan 25
In the treatment of non-healing cancerous wounds or ulcers, first thing is most important that is purification of the body or an individual through emesis (vamana), purgation (virechana), shashtra karma (surgery), and basti (oil or medicated decoction enema).
The above mentioned procedures should be advised after the patient’s physical assessment, and if done then the wound is treatable and facilitates quick healing of the cancerous wounds.
Treatment of non-healing cancer wounds or ulcers
पूर्वरूपं भिषग्बुद्ध्वा व्रणानां शोफमादितः|रक्तावसेचनं कुर्यादजात व्रण शान्तये ||४४|| Charaka Chikitsasthana 25
As per Ayurveda, it is well known fact that swelling is invariably associated with wounds and the same principle applies well in the management of non-healing cancer wounds or ulcers. Popularly, the shortest definition of cancer is ‘Cancer is wound that doesn’t heals’ due to associated chronic inflammation. Raktamokshana or blood-letting can help in reducing the swelling or inflammation associated with wounds.
Bloodletting through Leech therapy or Jalaukavacharana Raktamokshana (जलौकावचरण रक्त मोक्षण) in non-healing cancer wounds or ulcers
Leech therapy which is also alternatively known as hirudotherapy uses leeches to suck or consume the blood from the skins or superficial cancer lesions. Leeches are found all over the world in fresh waters, and are small and segmented worms. Leech therapy is mentioned in Ayurveda since many centuries, and is used to treat various conditions like gout, herpes, varicose veins, osteoarthritis, non-healing cancer wounds or ulcers etc.
Leech therapy helps in improving blood flow to the local area thereby reducing localized inflammation. Leech therapy is also believed to stimulate the immune system and thereby facilitating resolution of swelling and inflammation. This leech therapy should be done by trained ayurveda practitioners.
Upanaha Sweda (उपनाह स्वेद) or Poultice in non-healing cancer wounds or ulcers
तैलेन सर्पिषा वाऽपि ताभ्यां वा सक्तुपिण्डिका |सुखोष्णा शोफपाकार्थमुपनाहः प्रशस्यते ||५०||सतिला सातसीबीजा दध्यम्ला सक्तुपिण्डिका |सकिण्वकुष्ठलवणा शस्ता स्यादुपनाहने ||५१|| Charaka Chikitsasthana 25
A cancer related swelling which is developing below the skin and is yet to breach the skin layer can be treated through Upanaha Sweda (उपनाह स्वेद) or Poultice. In upanaha sweda or poultice, warm flour mixed with ghee and oil can be applied over the cancer related swelling and further help to reduce the inflammation or resolution of the doshas. In cancer related swelling upanaha sweda or poultice can be prepared from flour, tila (Sesamum indicum), linseeds (Linum usitatissimum), curd, yeast, kustha ((Saussurea lappa) and salt can be used in poultice.
Local application of alkali or Kshara Karma (क्षार कर्म) in non-healing cancer wounds or ulcers
रोग दोष बलापेक्षी मात्रा कालाग्निकोविदः |शस्त्रकर्माग्निकृत्येषु क्षारमप्यवचारयेत् ||१०७|| Charaka Chikitsasthana 25
Surgery or Agnikarma or Kshara Karma (क्षार कर्म) can be advised to cancer patient who is suffering from non-healing cancer wounds or ulcers considering factors like intensity of the doshas, bala or strength of the cancer patient, time like current season and Agni or digestive power of the cancer patient.
In Kshara Karma (क्षार कर्म) most commonly Apamarga Kshar (Achyranthes aspera) is applied over the non-healing cancer wounds or ulcers.
Dhoopana Karma or Fumigation in non-healing cancer wounds or ulcers
कठिनत्वं व्रणा यान्ति गन्धैः सारैश्च धूपिताः |सर्पिर्मज्जवसाधूपैः शैथिल्यं यान्ति हि व्रणाः ||१०८||रुजः स्रावाश्च गन्धाश्च कृमयश्च व्रणाश्रिताः |शैथिल्यं मार्दवं चापि धूपनेनोपशाम्यति ||१०९||लोध्र न्यग्रोधशुङ्गानि खदिरस्त्रिफला घृतम् |प्रलेपो व्रण शैथिल्य सौकुमार्यप्रसाधनः ||११०|| || Charaka Chikitsasthana 25
Hardness of the wound is a complication of non-healing cancer ulcers or wounds. In Ayurveda, it is mentioned as the wound which has gone hard now can be fumigated with aromatic material and extract of different ayurvedic plants like latex or sap.
Alternatively, the wounds can also become soft due to fumigation from ghee, bone marrow, and fat that lies in the muscle. Fumigation also help in multiple other complications of the cancer wounds like pain, foul smelling discharge, maggots infestation, hardness of the wounds etc.
Different oral medications and local applications for non-healing cancer wounds or ulcers
1) Triphala Guggul (त्रिफला गुग्गुलु) in non-healing cancer wounds or ulcers
Triphala Guggul is one of the most significant and a polyherbal formulation mentioned in Ayurveda. As per Ayurveda, Triphala Guggul proves beneficial in multiple conditions like cancer wounds, sotha (inflammation), arsha (piles), bhagandara (fistula), and various other ailments.
Triphala Guggul is prepared by adding Shuddha Guggul (Commiphora wightii) with fine powder of Haritaki (Terminalia chebula), Amlaki (Phyllanthus emblica), Vibhitaki (Terminalia bellirica), and Pippali (Piper longum). This mixture is pounded with adding ghee (Ghrita) in small amount, and a semi-solid consistency is achieved. Later a vati of 250 mg is rolled out and it is sundried. Triphala Guggul can be given with lukewarm water.
2) Gandhak Rasayan (गंधक रसायन) in non-healing cancer wounds or ulcers
Gandhaka Rasayana is a very beneficial drug in Ayurveda, and is beneficial against wide range of skin ailments like psoriasis, eczema, wounds or ulcers etc. Gandhaka Rasayana is also beneficial in non-healing cancer or wounds. Gandhaka Rasayana is prepared by titrating or giving bhavana to Gandhaka (Sulphur) 88 numbers of times with different juices and decoctions.
Gandhaka is purified with cow ghee and milk, and later bhavana or titration is given with Twak (Cinnamomum verum), Ela (Elettaria cardamomum), Patra (Abies Webbiana), Nagakeshara (Mesua ferrea), Guduchi (Tinospora cordifolia), Amlaki (Phyllanthus emblica), Haritaki (Terminalia chebula), Vibhitaki (Terminalia bellirica), Sunthi (Zingiber officinale), Bhingaraja (Eclipta alba), and Adhraka Swarasa (Zingiber officinale). Gandhaka Rasayana is a very beneficial herbo-mineral formulation mentioned in Ayurveda, and used against wide range of diseases like skin diseases, appetizer, respiratory ailments, osteo-arthritis, bladder diseases, and multiple pain symptoms.
3) Panchavalkala Kwatha (पंचवल्कल क्वाथ) or decoction wash or ointment in non-healing cancer wounds or ulcers
Panchavalkala Kwatha is one of the important formulation mentioned in Ayurveda, and has wide range of medicinal and therapeutic uses. Panchavalkala Kwatha is prepared taking coarse mixture or bharad Nyagrodha (Ficus bengaenesis), Ashvatha (Ficus religiosa), Udumbara (Ficus glomerata), Parisha (Thespesia populanea), and Plaksha (Ficus lacor), and preparing decoction of the same through procedure as laid down in Ayurveda texts.
Panchavalkala Kwatha is a combination of ayurvedic herbs which is Astringent or Kashay Rasatamaka in nature. It is a good anti-septic, anti-inflammatory, anti-bacterial, and a very good wound healing properties. Panchavalkala Kwatha can also prove beneficial in burn injury due to high dose radiotherapy.
Panchavalkala Kwatha ameliorate the bacterial infection, and improves local immunity thereby facilitating wound healing in cancer patients. Panchavalkala Kwatha through it stambhaka and grahi action helps to relieve symptoms of discharge and bleeding from non-healing cancer wounds or ulcers. Panchavalkala Kwatha through its Chedana and Lekhana action helps to dead and sloughed of tissue from non-healing cancer wounds or ulcers.
About Team ‘Cancer In Ayurveda’
Team “Cancer In Ayurveda” is a group of Ayurvedic Practitioners who are looking for scope of potential of Ayurveda in addressing of the deadliest disease called “Cancer”. Team “Cancer In Ayurveda” has inculcated into its wisdom a combined approach of traditional Ayurvedic principles and modern scientific understanding.
Team “Cancer In Ayurveda” has undertaken a tedious and admirable task with a commitment of bridging the gap between traditional Ayurvedic and conventional medicine in successful management of Cancer. An integration of ancient knowledge and modern science envisions a progressive and open-minded approach of team “Cancer In Ayurveda” in management of Cancer.
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