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Treatment of Cancer in Ayurveda
Om Saha Nau-Avatu | Om, May we all be protected 
Saha Nau Bhunaktu | 
Saha Viiryam 
Karavaavahai | 
Tejasvi Nau- 
Adhiitam-Astu 
Maa Vidvishaavahai | 
Om Shaantih Shaantih 
Shaantih || 
May we all be nourished 
May we work together with 
great energy 
May our intellect be 
sharpened 
Let there be no Animosity 
amongst us 
Om, peace (in me), peace 
(in nature), peace (in divine 
forces) 
Kathopanishad
Dr. Prashant Sawant, M.D. (Ayurved) 
Ayusanjivani Chikitsa, Mumbai 
drprashantsawant@gmail.com 
www.ayurlife.net
Role of Ayurveda in Managing 
Cancer 
 Case Studies 
 Understanding Cancer 
 Ayurveda Concepts 
 Ayurvedic Management 
 Q & A
Role of Ayurveda in Managing 
Cancer 
Case Studies 
 Bone metastases in renal cell carcinoma 
 Extensive bone and lung metastases in cancer of 
unknown primary (CUP) 
 Malignant Melanoma 
 Severe ano-rectal Pain in a Case of Metastatic Breast 
Cancer
RCC with Bone Metastases 
 Renal cell carcinoma (RCC) is the most common 
malignancy of the kidney [Jemal et al. 2009] 
 Almost 30% of patients with RCC present with metastatic 
disease 
 Bone is the common site of distant metastatic spread in 
patients with advanced RCC [Motzer et al. 2007, 2008]. 
 Metastatic bone disease causes significant morbidity 
through skeletal related events (SREs)
RCC with Bone metastases 
 The prognosis for any treated renal cell cancer patient 
with progressing, recurring, or relapsing disease is 
poor, regardless of cell type or stage. 
 Almost all patients with stage IV renal cell cancer are 
incurable (Kidney. In: Edge SB, Byrd DR, Compton CC, et al., eds.: 
AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010)
RCC with Bone metastases 
 The incidence of spontaneous regression of metastatic 
renal cell carcinoma is thought to be less than 1% of all 
cases. It is reported that complete regression is even 
rarer than partial regression 
 Since 2005, when targeted agents with activity against 
RCC began to appear, the median survival for patients 
with metastatic RCC has increased from 10 months to 
more than 20 months
RCC with Bone Metastases 
 We present a case of RCC with bone metastases, whose 
bone lesions were completely resolved after the 
ayurvedic treatment.
RCC with Bone Metastases 
26/11/2004 Male, age 41 yrs 
 C/o severe pain in the upper back, pain in the right 
flank and right side of the chest - over mid axillary 
line - since 15-20 days, which increased on cough 
impulse. He also complained of cough, pain and 
throat irritation 
 Painful body movements and pain in the left knee 
joint
RCC with Bone metastases 
H/o Presenting Complaints 
 k/c/o right renal cell carcinoma (RCC) Grade II, with 
multiple bone metastases (Stage IV) 
 Had pain in the ribcage bilaterally, since December 2001. 
 His physician advised him some NSAIDs. However, even 
after 2 months of treatment, the pain persisted. He was 
then advised bone scan.
RCC with Bone metastases 
 21/2/2002 Bone scan : 
revealed focal lesions on the 
costochondral junction of 
1st rib (both sides), 4th, 5th 
ribs (right side), 3rd rib (left 
side) and on D10, L1, L2, L3 
vertebrae.
RCC with Bone metastases 
 23/2/2002 MRI of L.S. 
Spine: revealed definite 
lesions on spine, involving 
the D10 pedicals and D9 
body. A mass was also seen 
in the right kidney (3.5 cm 
x 3 cm), strongly s/o a 
renal cell Ca.
RCC with Bone metastases 
 6/3/2002 : FNAC 
from the lesion 
confirmed RCC.
RCC with Bone metastases 
 On 11/3/2002, right radical nephrectomy was done. 
 The histopathology report confirmed Renal Cell Ca Grade 
II, Stage IV
RCC with Bone metastases 
March 2002: Conventional Treatment 
• Inj. Disodium Pamidronate 
• Inj. Intreferon alpha 
• Inj Interlukin II
Follow Up After Conventional 
Treatment 
1.11.02 : Bone scan: (@ 8 months) 
 Show abnormal tracer uptake– lateral end of left clavicle, 
right 10th rib postero laterally, L2 vertebra, tarsal region 
of the right foot and right calcaneum. The rest of the 
skeletal system shows normal tracer uptake. Left kidney is 
normal. Above mentioned osseous abnormalities appear 
like metastatic lesions
Follow Up After Conventional 
Treatment 
13.11.04 : Whole body Bone Scan (31 months of 
Conventional Rx) 
 Multiple skeletal metastases. 
 Fresh lesions in 7th rib left tibial tuberosity on right 
side, left navicular bone and lytic lesion of the 11th rib 
are seen in addition to lesion reported earlier studies.
RCC with Bone metastases 
 At this stage, the patient approached for ayurvedic 
treatment.
Ayurvedic Treatment 
26th Nov 2004 
 Ayurvedic poly-herbo-mineral formulations given as oral 
medicines twice a day with honey 
 Yapan Basti; a polyherbal medicinal preparation 
administered as an Enema given for 30 consecutive days 
 Followed by 8 Yapana Basti every 3 months.
Follow Up After Ayurvedic Rx 
 From the second week of treatment the pain and 
tenderness in the rib cage gradually reduced and was 
completely relived at the end of first cycle of Yapan Basti 
(30 basti)
Follow Up After Ayurvedic Rx 
22.03.05 : Whole body 
Bone scan (@ 3 months): 
Multiple skeletal 
metastases. Lesion in left 
7th rib, L2 vertebra, 
medial tuberosity of right 
Tibia are not visualized 
suggestive of regression of 
disease.
Follow Up After Ayurvedic Rx 
26.08.05 : Bone scan (8 
months after starting 
ayurvedic treatment) : 
 No evidence of skeletal 
metastases
Follow Up After Ayurvedic Rx 
31.08.05 PET scan (@ 8 
of ayurvedic treatment) : 
 Whole body survey is 
unremarkable.
Follow Up After Ayurvedic Rx 
18.07.06 Whole body 
PET (@ 19 months) 
 No definitive suggestion of 
any active disease on the 
present whole body 
21.08.06 (@ 20 months) 
 Ayurvedic medicines were 
stopped
Follow Up After Ayurvedic Rx 
27.07.10 Whole body PET 
scan (@ 6 years) : 
 No suggestion of any active 
disease
Follow Up After Ayurvedic Rx 
Bone Scan 09.11.2011 (@ 6 ½ 
years) 
 No e/o osteoblastic 
skeletal metastases 
Sept 2014 (@ 9 years) 
 Asymptomatic 
 Clinically disease free
Conclusion 
 The disease was progressing even after 2 ½ years of 
conventional treatment 
 The disease regressed after 3 months of ayurvedic treatment 
 The disease completely resolved after 8 months of ayurvedic 
treatment 
 The patient has DFS of over 8 ½ years 
 The QOL is maintained 
 There were no adverse effects of treatment
Case 2 
Extensive bone and lung metastases in cancer of 
unknown primary (CUP)
Cancer of unknown primary (CUP) 
 CUP is diagnosed at the metastatic stage and despite 
extensive diagnostic work-up the primary tumor often 
remains unidentified. 
 80-85% of CUP have very aggressive potential and 
unpredictable pattern of metastatic spread. The largest 
group of these tumors is refractory to standard 
chemotherapy 
 The overall prognosis of CUP patients is generally very 
poor with a median survival of 4-12 months 
[ Hainsworth JD, Gereco FA: Treatment of patients with cancer of unknown primary site. N Engl J 
Med 1993, 329(4):257-263]
Case Report - Extensive bone and 
lung metastases in CUP 
Male Age 57 years, resident of Goa 
 He was having right pelvic pain since Jan 08 
 He was treated by his family physician with NSAIDs 
for over 1 ½ year 
 As his symptoms worsened he was advised CT scan of 
pelvis in June 09
Case Report - Extensive bone and 
lung metastases in CUP 
06 June 09 
 CT scan Pelvis : multiple 
osteolytic pelvis lesions in 
the right iliac bone 
extending to the 
acetabulam 
 CT scan Thorax : multiple 
nodular lesions in both 
lung parenchyma (s/o 
metastases)
Case Report - Extensive bone and 
lung metastases in CUP 
 Tumor markers : non-contributory 
 23 June09 patient was referred to tertiary care center in 
Mumbai for further management.
Case Report - Extensive bone and 
lung metastases in CUP 
 23.06.09 : CT Thorax / Abdomen and pelvis 
Multiple lung parenchymal metastases are seen. 
Expansile osteolytic lesions are seen in the right 
iliac blade, accetabulum and sup pubic ramus. 
 01.07.09 : FNAC aspiration cytology of Lt lung - 
 Consistent with metastases of adeno-carcinoma
Case Report - Extensive bone and 
lung metastases in CUP 
 08.07.09 : After extensive investigations Oncologist 
remarked : 
• Extensive (metastatic) disease to unknown primary 
(CUP), tumor markers were non-contributory 
• Plan for symptomatic care 
• To consider palliative Chemo 
• To try Ayurveda treatment
Case Report - Extensive bone and 
lung metastases in CUP 
 10 July 09 : Patient approached for ayurvedic treatment
Case Report - Extensive bone and 
lung metastases in CUP 
10 July 09: C/o 
 Severe pain in right hip joint 
 Could walk on plain surface with support with extreme 
difficulty 
 Severe pain in both hip joint while walking
Case Report - Extensive bone and 
lung metastases in CUP 
10.07.09 : (1 month after diagnosis): 
Ayurvedic treatment 
 Herbo-mineral formulation, twice a day 
 Matra Basti fortnightly (from Oct 09)
Case Report - Extensive bone and 
lung metastases in CUP 
X-Ray Pelvis :12..11.11 CXR : 12..11.11
Case Report - Extensive bone and 
lung metastases in CUP 
29 Jan 2014 
 Patient was under treatment for around 4 years 9 
month 
 He was not taking any NSAIDs or other analgesics or 
any other conventional medicine 
 There were no SREs despite of extensive bone 
metastases 
 Though the patient had moderate pain and restricted 
movement of the hip, he was managing all his routine 
work comfortably
Conclusion 
 No conventional medicines used 
 No SREs despite of extensive bone metastases 
 No drug related side-effects 
 The progression of disease was curtailed and the patient 
survived with minimum morbidity for 5 years
Case 3 – Metastatic Malignant 
Melanoma
Case – Metastatic Malignant 
Melanoma 
Male Age 63 yrs 
 Oct 2007 
 Boil (lesion) of skin of Rt. Heel, thigh and lower leg 
 Inguinal Lymphadenopathy 
 3 Nov 07 Histopathology 
 Spindle cell melanoma of the skin of the heel
Case - Metastatic Malignant 
Melanoma 
 26 Nov 07 - CT Abdomen & Pelvis 
 Enhancing Rt. Inguinal lymphnodes likely to be 
metastasis 
 29 Nov 2007 : Whole Body PET 
 e/o Rt. Inguinal LN metastasis 
 Dec 2007 > Immunotherapy 
 Lesions increased gradually
Case - Metastatic Malignant 
Melanoma 
 7 August 2008 – PET 
Scan 
 Active disease in multiple 
nodules in right heel 
 HP: Rt. Thigh and leg 
biopsy 
 Malignant Melanoma 
 Advised Hip Articulation 
> Pt. refused
Case - Metastatic Malignant 
Melanoma 
 8 July 09 R/o the patient came for consultation 
 NE c/o 
 Multiple nodular lesions & sever pain in the rt. Leg 
 Large nodular ulcerative lesion on Rt. heel 
 Oozing ++ 
 Foul smell ++ 
 Swelling ++ 
 15 July 2009 – Ayurvedic treatment started 
 No Chemotherapy, No Radiation
2 ½ Months After Treatment 
17 Sept 09 
 No foul smell 
 No oozing 
 Reduction in swelling 
 Relief in pain 
 50 % reduction in Lesions 
 No new lesions 
 Patient could walk with support
Case - Malignant Melanoma 
Before Treatment 
4 July 09 
2 ½ Months After Treatment 
17 Sept 09
Conclusion 
 In this case of metastatic malignant melanoma the 
skin lesions reduced to around 50 % in 2 ½ months of 
ayurvedic treatment 
 No CT, RT or immunotherapy was used
Case 4 - Severe ano-rectal Pain in a 
Case of Metastatic Breast Cancer
Case - Severe ano-rectal Pain in a 
Case of Metastatic Breast Cancer 
Female Age 63 yrs Retired Professor 
28/02/14 c/o 
 Severe perianal & rectal pain not relived with anti-inflamatory 
analgesics or opioid analgesic (morphine) 
since 4 months 
 The pain lasted for 4-5 hours 
 The severity of pain compelled patient to lie in bed. 
She could not even stand or walk during these 
episodes
Case - Severe ano-rectal Pain in a 
Case of Metastatic Breast Cancer 
 H/o 
 DM since 5 years on OHA 
 HT since 15 years 
 Hysterectomy 2010 
 Fracture lt. femur 2011
Case - Severe ano-rectal Pain in a 
Case of Metastatic Breast Cancer 
 H/o Presenting Illness 
 Nov 12 she had palpable painful lump in left breast and a 
few palpable axilary lymph nodes 
 Few days later she developed severe ano-rectal pain 
which worsened after bowel movement 
 The pain continued even after a course of antibiotics and 
analgesics
Case - Severe ano-rectal Pain in a 
Case of Metastatic Breast Cancer 
 15.12.12 MRI Pelvis 
 Multiple small sub cm 
bilateral iliac nodes 
seen. 
 Multiple altered signal 
intensity lesions in Lt 
lateral mass of S3, 
bilateral iliac bones, Rt 
acetabulum, Rt ischium 
and neck and 
intertrochentric region 
of Lt femur-possibly 
marrow infiltrative 
lesions eg- metastasis/ 
myeloma.
Case - Severe ano-rectal Pain in a 
Case of Metastatic Breast Cancer 
 18.12.12 Whole body PET 
CT: 
 A moderate sized nodular 
lesion in the anterior 
chest wall 3.7x2.2 cm 
infiltrating the skin 
 e/o Lt axillary and sub 
pectoral adenopathy 
 Osseous lesion Rt. 
acetabulum
Case - Severe ano-rectal Pain in a 
Case of Metastatic Breast Cancer 
 15.1.13 Bone scan: 
 Abnormal osteoblastic 
activity involving the Rt 
acetabulam and Lt 
anterior superior iliac 
spine, 
 s/o skeletal mets. 
 Lt SI joint and Lt humeral 
head are suspicious for 
metastatic involvements.
Case - Severe ano-rectal Pain in a 
Case of Metastatic Breast Cancer 
10.1.13 
 Histopathology Lt axillary LN biopsy: Metastatic 
cancer, suspicious of breast origin. 
11.1.13 
 Histopathology IHC panel: Lt axillary LN biopsy 
 ER positive(60% tumour cells), PR positive (40% 
tumour cells), HER2neu –negative, GCDFP 15- positive.
Case - Severe ano-rectal Pain in a 
Case of Metastatic Breast Cancer 
 14.1.13 : The pain continued 
 Rx 
 Inj Zyphos 4mg/ IV once a month, 
 Tab Tamoxifen 20 mg od x 3 month, 
 Refereed to pain clinic for pain management 
 Tab Durogesic 25 tds 
 Tab PCM 625 qds 
 Tryptomer 10 mg HS 
 No CT or RT was advised
Case - Severe ano-rectal Pain in a 
Case of Metastatic Breast Cancer 
 The pain continued …… 
 28/2/13 Approached for ayurvedic treatment 
 Severe anorectal pain ++ 
 Patient was restless due to pain 
 O/e 
 P : 100, BP- 220/120, RS/CVS- N, Wt- 78, 
 PR- sentinel tag @ 3’O clock, pain ++ 
 No piles/fissure/fistula noted
Case - Severe ano-rectal Pain in a 
Case of Metastatic Breast Cancer 
 As the ano-rectal pain was very severe and was not 
relieved with opioid analgesic decided to give 
Anuvasan Basti followed by 30 Yapana basti 
 About an hour after giving anuvasana basti the pain was 
considerably reduced and patient went home 
 By night the pain subsided 
 Yapana basti and Medicines started from 29/02/13
Case - Severe ano-rectal Pain in a 
Case of Metastatic Breast Cancer 
 By 5th day the ano-rectal pain completely relieved 
 She removed Morphine patch on her own on 9th day 
and did not take single pain killer for any pain till date 
 Yapana basti x 8 repeated on 6/7/13 & 28/1/14 
 Last F/u 20/09/14 @ 19 months 
 Asymptomatic 
 No further investigation
Conclusion 
 The presenting complaint of severe anorectal and perineal 
pain, which was not relieved with morphine, etc. Had 
complete relief in pain in only 5 days of treatment 
 No CT or RT was given 
 On her last visit 19/09/14 , 22 months post detection of 
metastatic CA, she is asymptomatic 
 There is no clinical evidence of disease
What is Cancer? 
 leading cause of 
death 
 Estimated 14.1 million 
cancer cases around 
the world in 2012 
 Expected to increase 
to 24 million by 2035. 
Cancer statistics, 2014 
CA: A Cancer Journal for Clinicians 
Volume 64, Issue 1, pages 9-29, 7 JAN 2014 DOI: 10.3322/caac.21208 
http://onlinelibrary.wiley.com/doi/10.3322/caac.21208/full#caac21208-fig-0001
What is Cancer? 
 Diseases in which abnormal cells divide without 
control and are able to invade other tissues. 
 Cancer is not just one disease but many diseases. 
There are more than 100 different types of cancer. 
 Cancer cells can spread to other parts of the body 
through the blood and lymph systems. 
 Most cancers are named for the organ or type of cell in 
which they start – e.g. breast CA, Colon CA, Lung CA, 
etc.
Cell Lifespan 
 50 and 75 trillion cells in the body 
 Each type of cell has its own life span 
 Stomach 2 days 
 Spermatozoa 2-3 days 
 Colon 3-4 days 
 Platelets 10 days 
 Skin 19-34 days 
 Bone 25-30 years 
 Brain Lifetime
Treatment of Cancer in Ayurveda
Conventional Cancer Treatment 
 Surgery (for local and local-regional disease) 
 Radiation therapy (for local and local-regional disease) 
 Chemotherapy (for systemic disease) 
 Other important methods include 
 Hormonal therapy 
 Immunotherapy 
 Targeted drugs
Defining Response to Cancer 
Treatment 
 Cure : Long-term absence of symptoms or signs 
 Complete remission : Disappearance of clinical evidence 
 Partial response : 50% reduction in size of tumor mass or 
masses 
 Stable disease : Neither improvement nor worsening 
 Disease-free survival : Interval between disappearance of 
the tumor and relapse 
 Progression-free survival : Time from initiation of 
treatment to time of overt progression in a surviving 
patient 
 Survival time : Time from diagnosis to death
Ayurveda Concepts
Aims and Objectives 
Prevention 
Cure
“All powers in the Universe are already ours” 
- Swami Vivekanand 
Space 
Air 
Fire 
Water Earth
Ayurvedic Concepts of Disease 
Manifestation and Treatment 
Health = Equilibrium of 
 Dosha 
 Dhatu 
 Mala 
 Agni 
 Atma – Indriya - Mana
Ayurvedic Concepts of Disease 
Manifestation and Treatment 
Vata 
Pitta 
Kapha 
Dosha 
Sweda 
Mutra 
Purisha 
Mala 
Rasa 
Rakta 
Mansa 
Meda 
Asthi 
Majja 
Shukra 
Dhatu
Ayurvedic Concepts of Disease 
Manifestation and Treatment 
Transformation 
Agni 
Pitta
Ayurvedic Concepts of Disease 
Manifestation and Treatment 
Dosha at Cellular Level 
 Movement = Vata 
 Energy = Pitta > Agni 
 Bond = Kapha 
 Structure = Cell, 
physical dhatu =tissue 
Equilibrium of dosha and dhatu = Normal 
cellular functions and structure
Ayurvedic Concepts of Disease 
Manifestation and Treatment 
Molecular Basis of Rx 
 Dosha = Function = Physiological activities 
 Dhatu = (Davya) = Structure = Anatomy 
 Disease = Vitiated Dosha + Dushya blending
Ayurvedic Concepts of Disease 
Manifestation and Treatment 
Dosha vaishamya = imbalance of the 
function of the respective dosha 
Dhatu vaishamya = disruption of the 
cellular structure 
 Agni vaishamya = failure of proper 
transformation
Physiological Changes In Dosha 
Excitation 
Prakopa 
2 
Normalcy 
Prashama 
3 
Accumula 
tion 
Chaya 1 
Age 
Day 
Night 
Meal
Ayurvedic Concepts of Disease 
Manifestation and Treatment 
Excitation 
Prakopa 
2 
Accumula 
tion 
Chaya 1 
Normalcy 
Prashama 
3 
Spread 
Prasara 3 
Occupying 
Dhatu 
Sign / 
Symptoms 
Vyakti 5 
Differentiat 
ion 
Bheda 6 
6 Stages of disease 
manifestation
Ayurvedic Concepts of Disease 
Manifestation and Treatment 
D 
O 
S 
H 
A 
D 
U 
S 
H 
Y 
A 
Causative 
Factors 
Vata 
Pitta 
Kapha 
Rasa 
Rakta 
Mansa 
Meda 
Asthi 
Majja 
Shukra
Khavaigunya - Vulnerability
Khavaigunya - Vulnerability 
Rasa 
Mansa 
Meda 
Asthi 
Majja 
Shukra 
Pitta 
Kapha 
Vata 
Rakta
Blending of Vitiated Dosha and 
Dhatu 
Vata 
Pitta 
Kapha 
Rasa 
Rakta 
Mansa 
Meda 
Asthi 
Majja 
Shukra 
Rasa Rakta 
Disease 
Meda 
Vata 
Kapha 
Pitta 
Mansa 
Asthi 
Majja 
Shukra
Dissociation of Dosha and Dushya 
Blend Pitta 
Kapha 
Vata 
Rasa 
Disease Health 
Rakta 
Mansa 
Meda 
Asthi 
Majja 
Shukra 
Rasa Rakta 
Meda 
Vata 
Kapha 
Pitta 
Mansa 
Asthi 
Majja 
Shukra
Normal Cell Generation 
Normal Cell 
Genetic 
Information 
(Shukra Dhatu) 
Control 
Mechanism 
(Vata Dosh)
Cancerous Cell Generation 
Cancerous Cell 
Faulty Genetic 
Information 
(Shukra Dhatu) 
Defective Control 
Mechanism 
(Vitiated Vata 
Dosha)
Ayurvedic Management 
Excitation 
Prakopa 
2 
Accumula 
tion 
Chaya 1 
Normalcy 
Prashama 
3 
Spread 
Prasara 3 
Occupying 
Dhatu 
Sign / 
Symptoms 
Vyakti 5 
Differentiat 
ion 
Bheda 6 
6 Stages of disease 
manifestation
Bala – Immunity 
General 
Rasa 
Rakta 
Mansa 
Meda 
Asthi 
Majja 
Shukra 
Inherent Specific 
Strength
Bala - Immunity 
By birth 
Seasonal 
Acquired
Target of Treatment 
Control of Cell division 
Promoting Apoptosis 
Improving Tissue Immunity 
Fortifying defense of probable target 
tissue of metastases 
Preventing Recurrence
Basic Treatment Modalities 
Reducers 
(Langhana) 
Augmenters 
(Bruhana)
Basic Treatment Modalities 
Augmenters 
(Bruhana) 
Water 
Earth 
Reducers 
(Langhana) 
Space 
Air 
Fire
Basic Treatment Modalities 
Reducers 
(Langhana) 
Pacifiers 
(Shamana) 
Purifiers 
(Shodhana) 
Medicines that balances vitiated 
dosha without removing them 
from body 
Panchakarma 
Vamana, Virechana, Basti, 
Nasya, Raktamokshana 
Medicines that dislodge and 
expel vitiated dosha from body
Pharmacokinetics 
Taste (Rasa) 
Change in rasa after digestion (Vipaka) 
Change in Properties (Gunantara) 
Potency (Veerya) 
Character (Swabhava) 
Incomprehensible (Vichitra pratyarabdha)
Rasa Properties 
Augmenters 
Reducers 
Water 
Earth 
Sweet 
Fire 
Water 
Salty 
Fire 
Earth 
Amla 
Spac 
e 
Air 
Bitter 
Fir 
e 
Air 
Pungent 
Air 
Earth 
Astringent 
Absolute bruhana 
Absolute langhana 
Relative langhana
Reducers 
Change of taste 
post digestion - 
Vipaka 
Potency - Veerya 
Sweet Acidic 
Salty 
Hot Cold 
Independent of Digestive Fire
Treatment 
 Dosha balancing 
 Panchakarma 
Medicine 
 Rasayana 
 Dhatu Specific 
 Panchakarma 
Medicines 
 Rasayana
 Now let’s apply these concepts to our case
Cancerous Cell Generation 
Cancerous Cell 
Faulty Genetic 
Information 
(Shukra Dhatu) 
Little 
Recap 
Defective Control 
Mechanism 
(Vitiated Vata 
Dosha)
Vata 
Kapha 
Case 1 – RCC + Bonemets 
Pitta 
Kidneys 
Embryology 
Dhatu 
constituents 
Dosha 
Rakta 
Meda 
Cell 
replication 
Shukra 
Asthi 
Metastasis
Dosha Balancing Treatment 
 Basti 
 Panchakarma of choice for vata balancing 
Medicines given through rectal rout 
Large intestine main place of vatadosha 
Not for evacuation of bowl 
 Vatadosha balancing
Dosha Balancing Treatment 
 Yapana Basti Mustadi Yapana basti - Cha. Si 2/27 
 Yapana = Prolonging life, supportive to life, 
curing 
Benefits 
 Improves quality shukra, mansa and agni 
 Instantly strengthening 
 Cures vata pitta kapha and rakta mediated diseases 
 Rasayana
Medicine 
 Herbo-mineral formulation Containing: 
 Sitopaladi Churna 
 Hirak Bhasma 
 Shankhabhasma 
 Abhrak bhasma 
 Suvarna bhasma 
 Rajata bhasma 
 Tamra bhasma 
 Bruhatvata chintamani rasa 
 Makardhwaja rasa 
 Sheelajeet
Properties of Ingredients 
Medicine Main Properties 
Sitopaladi Churna Improves dhatu-agni, 
Hirak bhasma Best rasayana, rejuvenator, fertility 
promoter, aphrodisiac 
Shankha bhasma Useful in reducing tumor mass
Properties of Ingredients 
Medicine Main Properties 
Abhrak bhasma Promotes strength, useful in diseases 
of nervous system 
Suvarna bhasma Rasayana, Increases ‘oja’, 
Vayasthapana (enhances quality of 
life), 
Rajata Bhasma Lekhana (removes excess cells), Vata 
pacifier, rejuvenator,
Properties of Ingredients 
Medicine Main Properties 
Tamra Bhasma Lekhana, useful in vata-kapha 
diseases, useful in reducing tumor 
mass 
Bruhat Vata 
Chintamani Rasa 
Rasayana, strength promoter, fast 
acting, vata dosha balancing 
Makaradhwaja 
rasa 
Rasayana, improves fertility, restores 
physical and psychological strength, 
improves cell regeneration
Properties of Ingredients 
Medicine Main Properties 
Sheelajeet Rasayana, balances meda dhatu, 
Praval Pishti Tridosha shamak, strength enhancer, 
Mukta Pishti Rejuvenator, helps regeneration, 
medahara, prevents bone resorption
Outcome 
Normal Cell 
Faulty Genetic 
Information 
(Shukra Dhatu) 
Defective Control 
Mechanism 
(Vitiated Vata 
Dosha)
Treatment of Cancer in Ayurveda
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Treatment of Cancer in Ayurveda

  • 2. Om Saha Nau-Avatu | Om, May we all be protected Saha Nau Bhunaktu | Saha Viiryam Karavaavahai | Tejasvi Nau- Adhiitam-Astu Maa Vidvishaavahai | Om Shaantih Shaantih Shaantih || May we all be nourished May we work together with great energy May our intellect be sharpened Let there be no Animosity amongst us Om, peace (in me), peace (in nature), peace (in divine forces) Kathopanishad
  • 3. Dr. Prashant Sawant, M.D. (Ayurved) Ayusanjivani Chikitsa, Mumbai drprashantsawant@gmail.com www.ayurlife.net
  • 4. Role of Ayurveda in Managing Cancer  Case Studies  Understanding Cancer  Ayurveda Concepts  Ayurvedic Management  Q & A
  • 5. Role of Ayurveda in Managing Cancer Case Studies  Bone metastases in renal cell carcinoma  Extensive bone and lung metastases in cancer of unknown primary (CUP)  Malignant Melanoma  Severe ano-rectal Pain in a Case of Metastatic Breast Cancer
  • 6. RCC with Bone Metastases  Renal cell carcinoma (RCC) is the most common malignancy of the kidney [Jemal et al. 2009]  Almost 30% of patients with RCC present with metastatic disease  Bone is the common site of distant metastatic spread in patients with advanced RCC [Motzer et al. 2007, 2008].  Metastatic bone disease causes significant morbidity through skeletal related events (SREs)
  • 7. RCC with Bone metastases  The prognosis for any treated renal cell cancer patient with progressing, recurring, or relapsing disease is poor, regardless of cell type or stage.  Almost all patients with stage IV renal cell cancer are incurable (Kidney. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010)
  • 8. RCC with Bone metastases  The incidence of spontaneous regression of metastatic renal cell carcinoma is thought to be less than 1% of all cases. It is reported that complete regression is even rarer than partial regression  Since 2005, when targeted agents with activity against RCC began to appear, the median survival for patients with metastatic RCC has increased from 10 months to more than 20 months
  • 9. RCC with Bone Metastases  We present a case of RCC with bone metastases, whose bone lesions were completely resolved after the ayurvedic treatment.
  • 10. RCC with Bone Metastases 26/11/2004 Male, age 41 yrs  C/o severe pain in the upper back, pain in the right flank and right side of the chest - over mid axillary line - since 15-20 days, which increased on cough impulse. He also complained of cough, pain and throat irritation  Painful body movements and pain in the left knee joint
  • 11. RCC with Bone metastases H/o Presenting Complaints  k/c/o right renal cell carcinoma (RCC) Grade II, with multiple bone metastases (Stage IV)  Had pain in the ribcage bilaterally, since December 2001.  His physician advised him some NSAIDs. However, even after 2 months of treatment, the pain persisted. He was then advised bone scan.
  • 12. RCC with Bone metastases  21/2/2002 Bone scan : revealed focal lesions on the costochondral junction of 1st rib (both sides), 4th, 5th ribs (right side), 3rd rib (left side) and on D10, L1, L2, L3 vertebrae.
  • 13. RCC with Bone metastases  23/2/2002 MRI of L.S. Spine: revealed definite lesions on spine, involving the D10 pedicals and D9 body. A mass was also seen in the right kidney (3.5 cm x 3 cm), strongly s/o a renal cell Ca.
  • 14. RCC with Bone metastases  6/3/2002 : FNAC from the lesion confirmed RCC.
  • 15. RCC with Bone metastases  On 11/3/2002, right radical nephrectomy was done.  The histopathology report confirmed Renal Cell Ca Grade II, Stage IV
  • 16. RCC with Bone metastases March 2002: Conventional Treatment • Inj. Disodium Pamidronate • Inj. Intreferon alpha • Inj Interlukin II
  • 17. Follow Up After Conventional Treatment 1.11.02 : Bone scan: (@ 8 months)  Show abnormal tracer uptake– lateral end of left clavicle, right 10th rib postero laterally, L2 vertebra, tarsal region of the right foot and right calcaneum. The rest of the skeletal system shows normal tracer uptake. Left kidney is normal. Above mentioned osseous abnormalities appear like metastatic lesions
  • 18. Follow Up After Conventional Treatment 13.11.04 : Whole body Bone Scan (31 months of Conventional Rx)  Multiple skeletal metastases.  Fresh lesions in 7th rib left tibial tuberosity on right side, left navicular bone and lytic lesion of the 11th rib are seen in addition to lesion reported earlier studies.
  • 19. RCC with Bone metastases  At this stage, the patient approached for ayurvedic treatment.
  • 20. Ayurvedic Treatment 26th Nov 2004  Ayurvedic poly-herbo-mineral formulations given as oral medicines twice a day with honey  Yapan Basti; a polyherbal medicinal preparation administered as an Enema given for 30 consecutive days  Followed by 8 Yapana Basti every 3 months.
  • 21. Follow Up After Ayurvedic Rx  From the second week of treatment the pain and tenderness in the rib cage gradually reduced and was completely relived at the end of first cycle of Yapan Basti (30 basti)
  • 22. Follow Up After Ayurvedic Rx 22.03.05 : Whole body Bone scan (@ 3 months): Multiple skeletal metastases. Lesion in left 7th rib, L2 vertebra, medial tuberosity of right Tibia are not visualized suggestive of regression of disease.
  • 23. Follow Up After Ayurvedic Rx 26.08.05 : Bone scan (8 months after starting ayurvedic treatment) :  No evidence of skeletal metastases
  • 24. Follow Up After Ayurvedic Rx 31.08.05 PET scan (@ 8 of ayurvedic treatment) :  Whole body survey is unremarkable.
  • 25. Follow Up After Ayurvedic Rx 18.07.06 Whole body PET (@ 19 months)  No definitive suggestion of any active disease on the present whole body 21.08.06 (@ 20 months)  Ayurvedic medicines were stopped
  • 26. Follow Up After Ayurvedic Rx 27.07.10 Whole body PET scan (@ 6 years) :  No suggestion of any active disease
  • 27. Follow Up After Ayurvedic Rx Bone Scan 09.11.2011 (@ 6 ½ years)  No e/o osteoblastic skeletal metastases Sept 2014 (@ 9 years)  Asymptomatic  Clinically disease free
  • 28. Conclusion  The disease was progressing even after 2 ½ years of conventional treatment  The disease regressed after 3 months of ayurvedic treatment  The disease completely resolved after 8 months of ayurvedic treatment  The patient has DFS of over 8 ½ years  The QOL is maintained  There were no adverse effects of treatment
  • 29. Case 2 Extensive bone and lung metastases in cancer of unknown primary (CUP)
  • 30. Cancer of unknown primary (CUP)  CUP is diagnosed at the metastatic stage and despite extensive diagnostic work-up the primary tumor often remains unidentified.  80-85% of CUP have very aggressive potential and unpredictable pattern of metastatic spread. The largest group of these tumors is refractory to standard chemotherapy  The overall prognosis of CUP patients is generally very poor with a median survival of 4-12 months [ Hainsworth JD, Gereco FA: Treatment of patients with cancer of unknown primary site. N Engl J Med 1993, 329(4):257-263]
  • 31. Case Report - Extensive bone and lung metastases in CUP Male Age 57 years, resident of Goa  He was having right pelvic pain since Jan 08  He was treated by his family physician with NSAIDs for over 1 ½ year  As his symptoms worsened he was advised CT scan of pelvis in June 09
  • 32. Case Report - Extensive bone and lung metastases in CUP 06 June 09  CT scan Pelvis : multiple osteolytic pelvis lesions in the right iliac bone extending to the acetabulam  CT scan Thorax : multiple nodular lesions in both lung parenchyma (s/o metastases)
  • 33. Case Report - Extensive bone and lung metastases in CUP  Tumor markers : non-contributory  23 June09 patient was referred to tertiary care center in Mumbai for further management.
  • 34. Case Report - Extensive bone and lung metastases in CUP  23.06.09 : CT Thorax / Abdomen and pelvis Multiple lung parenchymal metastases are seen. Expansile osteolytic lesions are seen in the right iliac blade, accetabulum and sup pubic ramus.  01.07.09 : FNAC aspiration cytology of Lt lung -  Consistent with metastases of adeno-carcinoma
  • 35. Case Report - Extensive bone and lung metastases in CUP  08.07.09 : After extensive investigations Oncologist remarked : • Extensive (metastatic) disease to unknown primary (CUP), tumor markers were non-contributory • Plan for symptomatic care • To consider palliative Chemo • To try Ayurveda treatment
  • 36. Case Report - Extensive bone and lung metastases in CUP  10 July 09 : Patient approached for ayurvedic treatment
  • 37. Case Report - Extensive bone and lung metastases in CUP 10 July 09: C/o  Severe pain in right hip joint  Could walk on plain surface with support with extreme difficulty  Severe pain in both hip joint while walking
  • 38. Case Report - Extensive bone and lung metastases in CUP 10.07.09 : (1 month after diagnosis): Ayurvedic treatment  Herbo-mineral formulation, twice a day  Matra Basti fortnightly (from Oct 09)
  • 39. Case Report - Extensive bone and lung metastases in CUP X-Ray Pelvis :12..11.11 CXR : 12..11.11
  • 40. Case Report - Extensive bone and lung metastases in CUP 29 Jan 2014  Patient was under treatment for around 4 years 9 month  He was not taking any NSAIDs or other analgesics or any other conventional medicine  There were no SREs despite of extensive bone metastases  Though the patient had moderate pain and restricted movement of the hip, he was managing all his routine work comfortably
  • 41. Conclusion  No conventional medicines used  No SREs despite of extensive bone metastases  No drug related side-effects  The progression of disease was curtailed and the patient survived with minimum morbidity for 5 years
  • 42. Case 3 – Metastatic Malignant Melanoma
  • 43. Case – Metastatic Malignant Melanoma Male Age 63 yrs  Oct 2007  Boil (lesion) of skin of Rt. Heel, thigh and lower leg  Inguinal Lymphadenopathy  3 Nov 07 Histopathology  Spindle cell melanoma of the skin of the heel
  • 44. Case - Metastatic Malignant Melanoma  26 Nov 07 - CT Abdomen & Pelvis  Enhancing Rt. Inguinal lymphnodes likely to be metastasis  29 Nov 2007 : Whole Body PET  e/o Rt. Inguinal LN metastasis  Dec 2007 > Immunotherapy  Lesions increased gradually
  • 45. Case - Metastatic Malignant Melanoma  7 August 2008 – PET Scan  Active disease in multiple nodules in right heel  HP: Rt. Thigh and leg biopsy  Malignant Melanoma  Advised Hip Articulation > Pt. refused
  • 46. Case - Metastatic Malignant Melanoma  8 July 09 R/o the patient came for consultation  NE c/o  Multiple nodular lesions & sever pain in the rt. Leg  Large nodular ulcerative lesion on Rt. heel  Oozing ++  Foul smell ++  Swelling ++  15 July 2009 – Ayurvedic treatment started  No Chemotherapy, No Radiation
  • 47. 2 ½ Months After Treatment 17 Sept 09  No foul smell  No oozing  Reduction in swelling  Relief in pain  50 % reduction in Lesions  No new lesions  Patient could walk with support
  • 48. Case - Malignant Melanoma Before Treatment 4 July 09 2 ½ Months After Treatment 17 Sept 09
  • 49. Conclusion  In this case of metastatic malignant melanoma the skin lesions reduced to around 50 % in 2 ½ months of ayurvedic treatment  No CT, RT or immunotherapy was used
  • 50. Case 4 - Severe ano-rectal Pain in a Case of Metastatic Breast Cancer
  • 51. Case - Severe ano-rectal Pain in a Case of Metastatic Breast Cancer Female Age 63 yrs Retired Professor 28/02/14 c/o  Severe perianal & rectal pain not relived with anti-inflamatory analgesics or opioid analgesic (morphine) since 4 months  The pain lasted for 4-5 hours  The severity of pain compelled patient to lie in bed. She could not even stand or walk during these episodes
  • 52. Case - Severe ano-rectal Pain in a Case of Metastatic Breast Cancer  H/o  DM since 5 years on OHA  HT since 15 years  Hysterectomy 2010  Fracture lt. femur 2011
  • 53. Case - Severe ano-rectal Pain in a Case of Metastatic Breast Cancer  H/o Presenting Illness  Nov 12 she had palpable painful lump in left breast and a few palpable axilary lymph nodes  Few days later she developed severe ano-rectal pain which worsened after bowel movement  The pain continued even after a course of antibiotics and analgesics
  • 54. Case - Severe ano-rectal Pain in a Case of Metastatic Breast Cancer  15.12.12 MRI Pelvis  Multiple small sub cm bilateral iliac nodes seen.  Multiple altered signal intensity lesions in Lt lateral mass of S3, bilateral iliac bones, Rt acetabulum, Rt ischium and neck and intertrochentric region of Lt femur-possibly marrow infiltrative lesions eg- metastasis/ myeloma.
  • 55. Case - Severe ano-rectal Pain in a Case of Metastatic Breast Cancer  18.12.12 Whole body PET CT:  A moderate sized nodular lesion in the anterior chest wall 3.7x2.2 cm infiltrating the skin  e/o Lt axillary and sub pectoral adenopathy  Osseous lesion Rt. acetabulum
  • 56. Case - Severe ano-rectal Pain in a Case of Metastatic Breast Cancer  15.1.13 Bone scan:  Abnormal osteoblastic activity involving the Rt acetabulam and Lt anterior superior iliac spine,  s/o skeletal mets.  Lt SI joint and Lt humeral head are suspicious for metastatic involvements.
  • 57. Case - Severe ano-rectal Pain in a Case of Metastatic Breast Cancer 10.1.13  Histopathology Lt axillary LN biopsy: Metastatic cancer, suspicious of breast origin. 11.1.13  Histopathology IHC panel: Lt axillary LN biopsy  ER positive(60% tumour cells), PR positive (40% tumour cells), HER2neu –negative, GCDFP 15- positive.
  • 58. Case - Severe ano-rectal Pain in a Case of Metastatic Breast Cancer  14.1.13 : The pain continued  Rx  Inj Zyphos 4mg/ IV once a month,  Tab Tamoxifen 20 mg od x 3 month,  Refereed to pain clinic for pain management  Tab Durogesic 25 tds  Tab PCM 625 qds  Tryptomer 10 mg HS  No CT or RT was advised
  • 59. Case - Severe ano-rectal Pain in a Case of Metastatic Breast Cancer  The pain continued ……  28/2/13 Approached for ayurvedic treatment  Severe anorectal pain ++  Patient was restless due to pain  O/e  P : 100, BP- 220/120, RS/CVS- N, Wt- 78,  PR- sentinel tag @ 3’O clock, pain ++  No piles/fissure/fistula noted
  • 60. Case - Severe ano-rectal Pain in a Case of Metastatic Breast Cancer  As the ano-rectal pain was very severe and was not relieved with opioid analgesic decided to give Anuvasan Basti followed by 30 Yapana basti  About an hour after giving anuvasana basti the pain was considerably reduced and patient went home  By night the pain subsided  Yapana basti and Medicines started from 29/02/13
  • 61. Case - Severe ano-rectal Pain in a Case of Metastatic Breast Cancer  By 5th day the ano-rectal pain completely relieved  She removed Morphine patch on her own on 9th day and did not take single pain killer for any pain till date  Yapana basti x 8 repeated on 6/7/13 & 28/1/14  Last F/u 20/09/14 @ 19 months  Asymptomatic  No further investigation
  • 62. Conclusion  The presenting complaint of severe anorectal and perineal pain, which was not relieved with morphine, etc. Had complete relief in pain in only 5 days of treatment  No CT or RT was given  On her last visit 19/09/14 , 22 months post detection of metastatic CA, she is asymptomatic  There is no clinical evidence of disease
  • 63. What is Cancer?  leading cause of death  Estimated 14.1 million cancer cases around the world in 2012  Expected to increase to 24 million by 2035. Cancer statistics, 2014 CA: A Cancer Journal for Clinicians Volume 64, Issue 1, pages 9-29, 7 JAN 2014 DOI: 10.3322/caac.21208 http://onlinelibrary.wiley.com/doi/10.3322/caac.21208/full#caac21208-fig-0001
  • 64. What is Cancer?  Diseases in which abnormal cells divide without control and are able to invade other tissues.  Cancer is not just one disease but many diseases. There are more than 100 different types of cancer.  Cancer cells can spread to other parts of the body through the blood and lymph systems.  Most cancers are named for the organ or type of cell in which they start – e.g. breast CA, Colon CA, Lung CA, etc.
  • 65. Cell Lifespan  50 and 75 trillion cells in the body  Each type of cell has its own life span  Stomach 2 days  Spermatozoa 2-3 days  Colon 3-4 days  Platelets 10 days  Skin 19-34 days  Bone 25-30 years  Brain Lifetime
  • 67. Conventional Cancer Treatment  Surgery (for local and local-regional disease)  Radiation therapy (for local and local-regional disease)  Chemotherapy (for systemic disease)  Other important methods include  Hormonal therapy  Immunotherapy  Targeted drugs
  • 68. Defining Response to Cancer Treatment  Cure : Long-term absence of symptoms or signs  Complete remission : Disappearance of clinical evidence  Partial response : 50% reduction in size of tumor mass or masses  Stable disease : Neither improvement nor worsening  Disease-free survival : Interval between disappearance of the tumor and relapse  Progression-free survival : Time from initiation of treatment to time of overt progression in a surviving patient  Survival time : Time from diagnosis to death
  • 70. Aims and Objectives Prevention Cure
  • 71. “All powers in the Universe are already ours” - Swami Vivekanand Space Air Fire Water Earth
  • 72. Ayurvedic Concepts of Disease Manifestation and Treatment Health = Equilibrium of  Dosha  Dhatu  Mala  Agni  Atma – Indriya - Mana
  • 73. Ayurvedic Concepts of Disease Manifestation and Treatment Vata Pitta Kapha Dosha Sweda Mutra Purisha Mala Rasa Rakta Mansa Meda Asthi Majja Shukra Dhatu
  • 74. Ayurvedic Concepts of Disease Manifestation and Treatment Transformation Agni Pitta
  • 75. Ayurvedic Concepts of Disease Manifestation and Treatment Dosha at Cellular Level  Movement = Vata  Energy = Pitta > Agni  Bond = Kapha  Structure = Cell, physical dhatu =tissue Equilibrium of dosha and dhatu = Normal cellular functions and structure
  • 76. Ayurvedic Concepts of Disease Manifestation and Treatment Molecular Basis of Rx  Dosha = Function = Physiological activities  Dhatu = (Davya) = Structure = Anatomy  Disease = Vitiated Dosha + Dushya blending
  • 77. Ayurvedic Concepts of Disease Manifestation and Treatment Dosha vaishamya = imbalance of the function of the respective dosha Dhatu vaishamya = disruption of the cellular structure  Agni vaishamya = failure of proper transformation
  • 78. Physiological Changes In Dosha Excitation Prakopa 2 Normalcy Prashama 3 Accumula tion Chaya 1 Age Day Night Meal
  • 79. Ayurvedic Concepts of Disease Manifestation and Treatment Excitation Prakopa 2 Accumula tion Chaya 1 Normalcy Prashama 3 Spread Prasara 3 Occupying Dhatu Sign / Symptoms Vyakti 5 Differentiat ion Bheda 6 6 Stages of disease manifestation
  • 80. Ayurvedic Concepts of Disease Manifestation and Treatment D O S H A D U S H Y A Causative Factors Vata Pitta Kapha Rasa Rakta Mansa Meda Asthi Majja Shukra
  • 82. Khavaigunya - Vulnerability Rasa Mansa Meda Asthi Majja Shukra Pitta Kapha Vata Rakta
  • 83. Blending of Vitiated Dosha and Dhatu Vata Pitta Kapha Rasa Rakta Mansa Meda Asthi Majja Shukra Rasa Rakta Disease Meda Vata Kapha Pitta Mansa Asthi Majja Shukra
  • 84. Dissociation of Dosha and Dushya Blend Pitta Kapha Vata Rasa Disease Health Rakta Mansa Meda Asthi Majja Shukra Rasa Rakta Meda Vata Kapha Pitta Mansa Asthi Majja Shukra
  • 85. Normal Cell Generation Normal Cell Genetic Information (Shukra Dhatu) Control Mechanism (Vata Dosh)
  • 86. Cancerous Cell Generation Cancerous Cell Faulty Genetic Information (Shukra Dhatu) Defective Control Mechanism (Vitiated Vata Dosha)
  • 87. Ayurvedic Management Excitation Prakopa 2 Accumula tion Chaya 1 Normalcy Prashama 3 Spread Prasara 3 Occupying Dhatu Sign / Symptoms Vyakti 5 Differentiat ion Bheda 6 6 Stages of disease manifestation
  • 88. Bala – Immunity General Rasa Rakta Mansa Meda Asthi Majja Shukra Inherent Specific Strength
  • 89. Bala - Immunity By birth Seasonal Acquired
  • 90. Target of Treatment Control of Cell division Promoting Apoptosis Improving Tissue Immunity Fortifying defense of probable target tissue of metastases Preventing Recurrence
  • 91. Basic Treatment Modalities Reducers (Langhana) Augmenters (Bruhana)
  • 92. Basic Treatment Modalities Augmenters (Bruhana) Water Earth Reducers (Langhana) Space Air Fire
  • 93. Basic Treatment Modalities Reducers (Langhana) Pacifiers (Shamana) Purifiers (Shodhana) Medicines that balances vitiated dosha without removing them from body Panchakarma Vamana, Virechana, Basti, Nasya, Raktamokshana Medicines that dislodge and expel vitiated dosha from body
  • 94. Pharmacokinetics Taste (Rasa) Change in rasa after digestion (Vipaka) Change in Properties (Gunantara) Potency (Veerya) Character (Swabhava) Incomprehensible (Vichitra pratyarabdha)
  • 95. Rasa Properties Augmenters Reducers Water Earth Sweet Fire Water Salty Fire Earth Amla Spac e Air Bitter Fir e Air Pungent Air Earth Astringent Absolute bruhana Absolute langhana Relative langhana
  • 96. Reducers Change of taste post digestion - Vipaka Potency - Veerya Sweet Acidic Salty Hot Cold Independent of Digestive Fire
  • 97. Treatment  Dosha balancing  Panchakarma Medicine  Rasayana  Dhatu Specific  Panchakarma Medicines  Rasayana
  • 98.  Now let’s apply these concepts to our case
  • 99. Cancerous Cell Generation Cancerous Cell Faulty Genetic Information (Shukra Dhatu) Little Recap Defective Control Mechanism (Vitiated Vata Dosha)
  • 100. Vata Kapha Case 1 – RCC + Bonemets Pitta Kidneys Embryology Dhatu constituents Dosha Rakta Meda Cell replication Shukra Asthi Metastasis
  • 101. Dosha Balancing Treatment  Basti  Panchakarma of choice for vata balancing Medicines given through rectal rout Large intestine main place of vatadosha Not for evacuation of bowl  Vatadosha balancing
  • 102. Dosha Balancing Treatment  Yapana Basti Mustadi Yapana basti - Cha. Si 2/27  Yapana = Prolonging life, supportive to life, curing Benefits  Improves quality shukra, mansa and agni  Instantly strengthening  Cures vata pitta kapha and rakta mediated diseases  Rasayana
  • 103. Medicine  Herbo-mineral formulation Containing:  Sitopaladi Churna  Hirak Bhasma  Shankhabhasma  Abhrak bhasma  Suvarna bhasma  Rajata bhasma  Tamra bhasma  Bruhatvata chintamani rasa  Makardhwaja rasa  Sheelajeet
  • 104. Properties of Ingredients Medicine Main Properties Sitopaladi Churna Improves dhatu-agni, Hirak bhasma Best rasayana, rejuvenator, fertility promoter, aphrodisiac Shankha bhasma Useful in reducing tumor mass
  • 105. Properties of Ingredients Medicine Main Properties Abhrak bhasma Promotes strength, useful in diseases of nervous system Suvarna bhasma Rasayana, Increases ‘oja’, Vayasthapana (enhances quality of life), Rajata Bhasma Lekhana (removes excess cells), Vata pacifier, rejuvenator,
  • 106. Properties of Ingredients Medicine Main Properties Tamra Bhasma Lekhana, useful in vata-kapha diseases, useful in reducing tumor mass Bruhat Vata Chintamani Rasa Rasayana, strength promoter, fast acting, vata dosha balancing Makaradhwaja rasa Rasayana, improves fertility, restores physical and psychological strength, improves cell regeneration
  • 107. Properties of Ingredients Medicine Main Properties Sheelajeet Rasayana, balances meda dhatu, Praval Pishti Tridosha shamak, strength enhancer, Mukta Pishti Rejuvenator, helps regeneration, medahara, prevents bone resorption
  • 108. Outcome Normal Cell Faulty Genetic Information (Shukra Dhatu) Defective Control Mechanism (Vitiated Vata Dosha)

Editor's Notes

  1. Om Saha Nau-Avatu | Saha Nau Bhunaktu | Saha Viiryam Karavaavahai | Tejasvi Nau-Adhiitam-Astu Maa Vidvissaavahai | Om Shaantih Shaantih Shaantih || Kathopanisad
  2. Renal cell carcinoma (RCC) is the most common malignancy of the kidney. In 2007, just under 58,000 people in the United States developed RCC and 12,980 died from the disease [Jemal et al. 2009]. The incidence of RCC has been increasing by about 3% per year in North Americans, with the highest rates now seen among African Americans [McLaughlin and Lipworth, 2000]. Almost 30% of patients with RCC present with metastatic disease, and furthermore, about 40% of patients who undergo resection of their primary with curative intent will relapse with disseminated disease [Motzer et al. 1996]. Bone is the second most common site of distant metastatic spread (following lung) in patients with advanced RCC. About one-third of patients in modern randomized trials of targeted therapies for advanced RCC have bone metastases [Rini et al. 2008; Motzer et al. 2007, 2008]. http://www.cancer.gov/cancertopics/pdq/treatment/renalcell/HealthProfessional/page8#Reference8.1
  3. Kidney. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 479-89
  4. A new era in the treatment of metastatic RCC commenced around 2005, when targeted agents with activity against RCC began to appear. Since that time, the median survival for patients with metastatic RCC has increased from 10 months to more than 20 months. Bone metastases in patients with renal cell carcinoma (RCC) are associated with a high risk of skeletal complications. About 40% of patients with RCC develop bone metastases. RCC is the fourth most common metastatic tumor of the spine and the most common cancer to present as a neurologic deficit secondary to an undetected primary malignancy. Chemotherapy and hormone therapy are ineffective, making radiation and surgery the mainstays of treatment. Failure to respond to or relapse after radiotherapy is common (American Journal of Neuroradiology 22:997-1003 (5 2001)   The median survival time with distant metastatic RCC is around 6 months, and few cases survive beyond 2 years. The incidence of spontaneous regression of metastatic renal cell carcinoma is thought to be less than 1% of all cases. It is reported that complete regression is even rarer than partial regression   We present a case of RCC with bone metastases, whose bone lesions were completely resolved after the ayurvedic multi-modality treatment.
  5. A new era in the treatment of metastatic RCC commenced around 2005, when targeted agents with activity against RCC began to appear. Since that time, the median survival for patients with metastatic RCC has increased from 10 months to more than 20 months. Bone metastases in patients with renal cell carcinoma (RCC) are associated with a high risk of skeletal complications. About 40% of patients with RCC develop bone metastases. RCC is the fourth most common metastatic tumor of the spine and the most common cancer to present as a neurologic deficit secondary to an undetected primary malignancy. Chemotherapy and hormone therapy are ineffective, making radiation and surgery the mainstays of treatment. Failure to respond to or relapse after radiotherapy is common (American Journal of Neuroradiology 22:997-1003 (5 2001)   The median survival time with distant metastatic RCC is around 6 months, and few cases survive beyond 2 years. The incidence of spontaneous regression of metastatic renal cell carcinoma is thought to be less than 1% of all cases. It is reported that complete regression is even rarer than partial regression   We present a case of RCC with bone metastases, whose bone lesions were completely resolved after the ayurvedic multi-modality treatment.
  6. Table. TNM Classification for Renal Cell Carcinoma (Open Table in a new window) Primary tumors (T)TXPrimary tumor cannot be assessedT0No evidence of primary tumorT1Tumor ≤7 cm in greatest dimension, limited to the kidneyT1aTumor ≤4 cm in greatest dimension, limited to the kidneyT1bTumor >4 cm but ≤7 cm in greatest dimension, limited to the kidneyT2Tumor >7 cm in greatest dimension, limited to the kidneyT2aTumor >7 cm but ≤10 cm in greatest dimension, limited to the kidneyT2bTumor >10 cm, limited to the kidneyT3Tumor extends into major veins or perinephric tissues but not into the ipsilateral adrenal gland and not beyond the Gerota fasciaT3aTumor grossly extends into the renal vein or its segmental (muscle-containing) branches, or tumor invades perirenal and/or renal sinus fat but not beyond the Gerota fasciaT3bTumor grossly extends into the vena cava below the diaphragmT3cTumor grossly extends into the vena cava above the diaphragm or invades the wall of the vena cavaT4Tumor invades beyond the Gerota fascia (including contiguous extension into the ipsilateral adrenal gland)Regional lymph node (N)NXRegional lymph nodes cannot be assessedN0No regional lymph node metastasesN1metastases in regional lymph node(s)Distant metastases (M)M0No distant metastasesM1Distant metastases Table. Anatomic stage/prognostic groups (Open Table in a new window) StageTNMIT1N0M0IIT2N0M0IIIT1-2N1M0T3N0-1M0IVT4N2M0Any TAny NM1
  7. In metasatic bone cancer, Pamidronate (‘Aredia’) is used, along with cancer therapy. The dual benefits of Aredia are delay and reduction of bone complications, such as fractures, and the possibility of reducing bone pain. It is the only medication approved for the treatment of bone metastases. This medication acts on bone to help regulate blood calcium levels. It is used to treat Paget's disease of bone and to treat high blood calcium levels. The medication has also been used in the treatment of osteoporosis, to reduce bone pain associated with certain illnesses and to treat bone loss due to breast cancer.   Immunotherapy was first introduced in the 1980s, and it provided another therapeutic alternative for distant metastatic RCC. The current regimens of immuno-therapy for distant metastatic RCC vary greatly but the main regimens are based on interferon alpha and interleukin-2. In comparison to cases without immuno- therapy, interferon alpha can prolong the median survival time by 2.6 months.   Interleukin-2 is one of the activators between T cells and natural killer cells. The overall survival time with interleukin-2 based adjuvant immunotherapy after a cytoreductive nephrectomy was 16.7 months in one study.   To conclude, previously, the median survival of patients with distant metastatic RCC was only 6 months. Adjuvant immunochemotherapy can increase the median survival time to more than 20 months. Inj. Disodium Pamidronate Inj. Intreferon alpha Inj Interlukin II Aredia (Inj. Disodium Pamidronate) 15mg x VIAL - Aredia INJ 2579.00    Aredia 30mg x VIAL - Aredia INJ 5158.00    Aredia 60mg x VIAL - Aredia INJ 10316.00    Intalfa 3 MIU x 1mL 1 Intalfa PFS 603.00 Interferon alfa-2a is a protein. Interferons are released in the body in response to viral infections. Interferons are important for fighting viruses in the body, regulating reproduction of cells, and regulating the immune system. Interferon alfa-2a is used to treat chronic hepatitis C, hairy cell leukemia, AIDS-related Kaposi's sarcoma, and some types of chronic myelogenous leukemia (CML). Pharmacokinetics Interferon alfa-2a has antiviral, antitumour and immunomodulatory activity. It inhibits replication of a wide range of RNA and DNA viruses. It also exerts antiproliferative effects on normal and malignant cells. Interferon alfa-2a suppresses antibody formation through an effect on B-lymphocytes and inhibits onset of delayed hypersensitivity. Absorption >80% is absorbed (IM); peak plasma concentrations within 4-8 hours (IM). Excretion Via urine (negligible amounts); 3.7-8.5 hours (elimination half-life). Interferon Alfa-2A Adverse Reactions / Interferon Alfa-2A Side Effects Depressive illness, suicidal behaviour, irritability, insomnia, anxiety. Flu-like symptoms. Headache, dizziness, paraesthesia, confusion, impaired concentration, alteration in taste or smell. GI disturbances. Dryness of oropharynx, epistaxis, rhinitis, arrhythmia, sinusitis. Inj site reaction, alopecia, rash, dry skin or pruritus. Conjunctivitis, menstrual irregularity, visual disturbances. Coughing, dyspnoea. Myalgia, joint or bone pain, arthritis or polyarthritis. Bone marrow depression. Potentially Fatal: Marked increase in triglyceride levels, GI haemorrhage, severe infections, pulmonary infiltrates or pulmonary function impairment.  
  8. No Conventional Medicines ? Ayurvedic poly-herbo-mineral formulations given as oral medicines twice a day with honey Therapeutic Panchakarma procedure viz Yapan Basti , a polyherbal medicinal preparation administered as an Enema given for 30 consecutive days
  9. 48+19 67
  10. 48+19 67
  11. Progression Free Survival
  12. Cancer of unknown primary (CUP) is diagnosed at the metastatic stage and despite extensive diagnostic work-up the primary tumor often remains unidentified. Limited population-based survival data are available for metastatic location and none are available that link the location with the cause of death, which might give clues about the tissue-of-origin. A total of 9,306 CUP patients with extranodal metastases of adenocarcinoma and undifferentiated histology were identified from the Swedish Cancer Registry. Hazard ratios (HRs), mean survival times and Kaplan-Meier survival curves were provided according to CUP location at diagnosis and cause of death. The median survival was shortest (2 months) for patients with liver and longest (5 months) for those with nervous system metastases. Lung cancer was the most common cause of death in patients with CUP metastases in the respiratory system, nervous system, bone and skin, with a median survival of 3 months. Patients with peritoneal/retroperitoneal and pelvical metastases died not only of ovarian cancer, with a favorable median survival of 8 months, but also of pancreatic and colorectal cancers. Patients with pancreatic, liver, biliary and colorectal cancers with liver metastases succumbed quickly. The data show that the location of metastases predicts site-specific cancer deaths which in turn may point to the hidden primary tumor. The results should facilitate the management of CUP in proposing that the diagnostic arsenal should target the lungs when metastases are diagnosed in the respiratory or nervous system, bone or skin; ovarian tumors should be suspected after diagnosis of pelvical metastases. Copyright © 2012 UICC. PMID: 23233409 [PubMed - in process] very aggressive potential and unpredictable pattern of metastatic spread. The largest group of these tumours is refractory to standard chemotherapy and the median survival of CUP patients is very low.
  13. Mr. AK is a 50 year old male residing in Goa. He is having right pelvic pain since last 1.5 years (since Jan 08). He was treated by his family physician with NSAIDs. As his symptoms worsened even after taking medicines for long, he was advised CT scan of pelvis in June 09. In this CT scan multiple osteolytic pelvis lesions are noted in the right iliac bone extending to the acetabulam (s/o metastases). CT scan of thorax was done, which revealed multiple nodular lesions in both lung parenchyma (s/o metastases). On 23 June09 patient was referred to tertiary care center in Mumbai (Tata Hospital) for further management. After extensive investigations TATA hospital doctors 08.07.09 remarked – Extensive (metastatic) disease to unknown primary, tumour markers were non-contributory Plan for symptomatic care Option of Alternative medicine (Ayurveda) given by the oncologist Advised to consider palliative Chemo Therapy for symptom control and to maintain good general condition if symptoms are severe     On 10 July 09 patient approached for ayurvedic treatment. He was able to walk with support, walking was very painful as slight pressure on right leg worsened pain. He can manage to walk on plain surface. He cannot slip on right side as it worsens his pain.   He also complains of right hip joint pain and dribbling micturation since about last 1.5 years.  
  14. CT scan multiple osteolytic pelvis lesions are noted in the right iliac bone extending to the acetabulam (s/o metastases). CT scan of thorax was done, which revealed multiple nodular lesions in both lung parenchyma (s/o metastases) CT Pelvis- 06.06.09 Multiple osteolytic pelvic lesions, s/o metastases. Expansile osteolytic lesions are noted in the right iliac bone extending into the acetabulum with destruction of the overlying cortex at places with extraosseus tissue component. Similar osteolytic lesions also noted in the sup pubic ramus on the right side.   CT Thorax - 06.06.09 Multiple nodular lesions are noted in both lung parenchyma s/o hematogenous metastases no lymphadenopathy.  
  15. CT Thorax / Abdomen and pelvis (P+C) at TATA Hospital: 23.06.09 Multiple lung parenchymal metastases are seen. Expansile osteolytic lesions are seen in the right iliac blade, accetabulum and sup pubic ramus.   FNAC aspiration cytology of Lt lung- 01.07.09 Consistent with metastases of adeno carcinoma
  16. 23 June09 patient was referred to tertiary care center in Mumbai (Tata Hospital) for further management. After extensive investigations TATA hospital doctors 08.07.09 remarked – Extensive (metastatic) disease to unknown primary, tumour markers were non-contributory Plan for symptomatic care Option of Alternative medicine (Ayurveda) given by the oncologist Advised to consider palliative Chemo Therapy for symptom control and to maintain good general condition if symptoms are severe
  17. On 10 July 09 patient approached for ayurvedic treatment. He was able to walk with support, walking was very painful as slight pressure on right leg worsened pain. He can manage to walk on plain surface. He cannot slip on right side as it worsens his pain.   He also complains of right hip joint pain and dribbling micturation since about last 1.5 years.
  18. started on Herbo-mineral formulation, twice a day with Honey and cow’s ghee, after food, Chandraprabha vati 2-2-2 Matra Basti fortnightly since Oct 09
  19. Conclusion:   Disease is in status-quo condition which is important in view of extensive bone and lung metastases.
  20. The incidence of melanoma is increasing at a dramatic rate worldwide. One in 75 Americans will have developed melanoma in the year 2000. [1] Most patients present with early-stage disease that is potentially curable with surgery alone in up to 90% of patients. However, the prognosis for patients with more advanced disease with involvement of regional lymph nodes or distant metastasis is poor, with median survival rates of 24 and 6 months, respectively. In the last few
  21. Mrs RS is a 63 yr old, Christian lady. She got retired as a college professor…. yrs back. As pain was severe, unbearable with all oral analgesics and Morphine patch since last 4 months, pt consulted us on 28.2.13 C/O: Sev PR pain continuous with acute onset of nature which lasts for 5-6 hr and pt has to lie in bed as difficulty in standing / walking. In supine lying position also pt doesn’t get relief. Pt describes this pain as ‘andar se kuch khichata hai’ n so sev that she unable to move/eat during pain. There was polyurea and mild dysurea . bowl was N, sleep less/disturbed as pain use to start at any time of the day. There was mild pain in low back and hips since last 2 months. No weight loss or pain in breast or lump noted, anxiety++ and her gait was exhausted and very slow due to pain. She was unable to sit in clinic for 15-20 mins also.
  22. Till 1st week of November 12 she was asymptomatic. In second week of Nov 12 she developed boil over Lt breast and few axillary nodes were palpable. The lump was palpable and painful. She consulted @ Fortis Hosp, finding were inflammatory? - Infected sebaceous cyst in Lt breast. Treatment given was course of antibiotics for 5 days. After medications there was regression in axillary nodes. By the time she developed sev pricking pain in perianal region more on Rt side which gets worse after defecation, the pain was continuous, intense and nagging in nature. She did MRI pelvis on 15.12.12 which showed multiple sub centric bilateral iliac nodes s/o metastasis. [Q- ?? PR pain/lump was prim symptom. If pain sev then why late in consultation, what Rx did initially] On 17.12.12 she consulted in Fortis for PR pain. There was no PR bleed, PR burning, piles or fissures. Pain severity has increased now- continuous daily pain. There was h/o constipation and straining type 1-2 on BRISTOL scale. Loss of sleep , polyurea and dysurea . There was no weight loss. PR exam/ proctoscopy were normal. She was advice T Tryptomer and further Investigation. S Creat came 1.4 with LDH 208. Whole body PET CT Scan done on 18.12.12 showed suspicious multiple bone lesions. As there was no relief in pain on 5th Jan 13 they consulted in SevenHills hosp. There was PR tenderness in perianal R from 3’O clock till 6’O clock, o/e no PR spasm, ? intersphincteric abscess on the Lt side, Lt breast lump palpable LT upper and inner quadrant 3x3 cm, inflammation+ with bloody discharge. Treatment started T Ultracet, Proxyvon and Tryptomer with Softovac poder 2tsf, HS. On 8th Jan she went in Tata. 3 mobile hard, ipsilateral lymph nodes were palpable with Lt breast lump in upper outer quadrant 2x1cm, matted. Histopath of same was advised. She was advised biopsy of Lt breast lump by both Tata n Seven hills hosp which she did on 9th Jan. Histopath of Lt axillary lymph node biopsy report showed metastatic cancer suspicious of breast origin. IHC panel confirmed the diagnosis as metastatic duct cancer of Lt axillary node ER/PR positive, HER2neu negative, GCDFP15 positive. As pain was very severe which was not relived by analgesics and she diagnosed as cancer, for further opinion she again consulted in SL Raheja and Tata hosp oncology dept on 14.1.13 Dr‘s remark on her status is – pain does not correlate with the radiology findings of accetabular lesion, may be due to infective focus. Like to review Xray PBH, if no lesion appreciated RT might not be indicated. On same date after opinion from Joint clinic, Dr Badwe advised Inj Zyphos 4mg/ IV once a month, T Tamoxifen 20 mg oncex 3 month, no RT suggested at present, pt ref to pain clinic for pain management Pt seen in pain clinic @ Tata. Proctoscopy, PS, PV, PR, cervical examinations were normal. X ray PBH was normal. They have advised T Durogesic 25, PCM 625 qds, Tryptomer 10 mg HS, Pan40 od as creat was 1.4, in addition to Morphine patch (when gave??? ) as pain was sev & continuous. As pain was severe, unbearable with all oral analgesics and Morphine patch since last 4 months, pt consulted us on 28.2.13
  23. 15.12.12 MRI Pelvis: (Jaipur) No obvious collection/fistula seen in perirectal region or ischiorectal fossa. Multiple small sub cm bilateral iliac nodes seen. Multiple altered signal intensity lesions in Lt lateral mass of S3, bilateral iliac bones, Rt acetabulum, Rt ischium and neck and intertrochentric region of Lt femur-possibly marrow infiltrative lesions eg- metastasis/ myeloma.
  24. Histopath of Lt axillary lymph node biopsy report showed metastatic cancer suspicious of breast origin. IHC panel confirmed the diagnosis as metastatic duct cancer of Lt axillary node ER/PR positive, HER2neu negative, GCDFP15 positive.
  25. 10.1.13 Histopathology Lt axillary LN biopsy: Metastatic cancer, suspicious of breast origin. 11.1.13 Histopatholgy IHC panel: Lt axillary LN biopsy ER positive(60% tumour cells), PR positive (40% tumour cells), HER2neu –negative, GCDFP 15- positive.IHC panel confirms metastatic duct cancer of Lt axillary node.
  26. As pain was very severe which was not relived by analgesics and she diagnosed as cancer, for further opinion she again consulted in SL Raheja and Tata hosp oncology dept on 14.1.13 Dr‘s remark on her status is – pain does not correlate with the radiology findings of accetabular lesion, may be due to infective focus. Like to review Xray PBH, if no lesion appreciated RT might not be indicated. On same date after opinion from Joint clinic, Dr Badwe advised Inj Zyphos 4mg/ IV once a month, T Tamoxifen 20 mg oncex 3 month, no RT suggested at present, pt ref to pain clinic for pain management Pt seen in pain clinic @ Tata. Proctoscopy, PS, PV, PR, cervical examinations were normal. X ray PBH was normal. They have advised T Durogesic 25, PCM 625 qds, Tryptomer 10 mg HS, Pan40 od as creat was 1.4, in addition to Morphine patch (when gave??? ) as pain was sev & continuous. As pain was severe, unbearable with all oral analgesics and Morphine patch since last 4 months, pt consulted us on 28.2.13
  27. O/E: P 100, BP- 220/120, RS/CVS- N, Bowl- 1 or 2 , soft, Mictu- every 2-3 hrly with mild pain, wt- 78, Lt ankle swelling (H/O # Lt femur), PR- sentinel tag @ 3’O clock, pain more on 12-3 O’ clock position and somewhere mid to 3-6 O’clock position, n piles/fissure/fistula noted, not much tender to touch, no breast lump/ axillary LN palpable As pt was in terrible pain we decided to give Matra basti stat and asked her to start yapan basti asap. Matra basti of 40 ml of Sahachar tel with lower abdominal and perianal snehan swedan done at about 4pm. Pt retained the basti oil for 4-5 hrs and passed one soft motion around 9pm. While going home in hour she felt pain intensity is less and become lesser till night. As she had relief in pain and severity was reduced, from next day she opt for 30 days course of YapanB. Next day we gave her YapanB, that day she experienced severe acute onset pain twice in a day but severity was less. On 3rd Dy she came for basti saying there is no pain since morning, again we gaved her Yapan B. On 4th day there was moderate pain since morn but with 60% relief in pain intensity and frequency. On 5th Dy she told there is no pain since yest eve after B and she not took any single pain killer since morning (she took Nt’s dose as routine), her BP was settled to 140/70 with P 88 now, which we have recorded daily was 180-190 systolic and 110-100 diastolic prev (due to pain n stress) [On 8th Dy she had C/O PR burn and sudden current like PR pain since yest eve which lasts for seconds and disappears… basti continued] From 5th day onwards, pt didn’t complain about PR pain as she got 100% relief with basti and medicines. She removed Morphine patch on her own on 9th day and not took single pain killer for any pain till date.
  28. O/E: P 100, BP- 220/120, RS/CVS- N, Bowl- 1 or 2 , soft, Mictu- every 2-3 hrly with mild pain, wt- 78, Lt ankle swelling (H/O # Lt femur), PR- sentinel tag @ 3’O clock, pain more on 12-3 O’ clock position and somewhere mid to 3-6 O’clock position, n piles/fissure/fistula noted, not much tender to touch, no breast lump/ axillary LN palpable As pt was in terrible pain we decided to give Matra basti stat and asked her to start yapan basti asap. Matra basti of 40 ml of Sahachar tel with lower abdominal and perianal snehan swedan done at about 4pm. Pt retained the basti oil for 4-5 hrs and passed one soft motion around 9pm. While going home in hour she felt pain intensity is less and become lesser till night. As she had relief in pain and severity was reduced, from next day she opt for 30 days course of YapanB. Next day we gave her YapanB, that day she experienced severe acute onset pain twice in a day but severity was less. On 3rd Dy she came for basti saying there is no pain since morning, again we gaved her Yapan B. On 4th day there was moderate pain since morn but with 60% relief in pain intensity and frequency. On 5th Dy she told there is no pain since yest eve after B and she not took any single pain killer since morning (she took Nt’s dose as routine), her BP was settled to 140/70 with P 88 now, which we have recorded daily was 180-190 systolic and 110-100 diastolic prev (due to pain n stress) [On 8th Dy she had C/O PR burn and sudden current like PR pain since yest eve which lasts for seconds and disappears… basti continued] From 5th day onwards, pt didn’t complain about PR pain as she got 100% relief with basti and medicines. She removed Morphine patch on her own on 9th day and not took single pain killer for any pain till date.
  29. Cancer is a leading cause of death worldwide and the total number of cases globally is increasing. There were an estimated 14.1 million cancer cases around the world in 2012, of these 7.4 million cases were in men and 6.7 million in women. This number is expected to increase to 24 million by 2035.
  30. Cancer is a term used for diseases in which abnormal cells divide without control and are able to invade other tissues. Cancer cells can spread to other parts of the body through the blood and lymph systems. Cancer is not just one disease but many diseases. There are more than 100 different types of cancer. Most cancers are named for the organ or type of cell in which they start - for example, cancer that begins in the colon is called colon cancer; cancer that begins in basal cells of the skin is called basal cell carcinoma.
  31. There are between 50 and 75 trillion cells in the body.... Each type of cell has its own life span, Cell type Length of time   Red blood 120 days Lymphocytes Over one year Other white 10 hours Platelets 10 days Bone 25-30 years Brain Lifetime Colon 3-4 days Skin 19-34 days Spermatozoa 2-3 days Stomach 2 days
  32. Thus cancer often explodes in something akin to a chain reaction caused by a few errors, which compound into more severe errors. Errors which produce more errors are effectively the root cause of cancer, and also the reason that cancer is so hard to treat: even if there were 10,000,000,000 cancerous cells and one killed all but 10 of those cells, those cells (and other error-prone precancerous cells) could still self-replicate or send error-causing signals to other cells, starting the process over again. This rebellion-like scenario is an undesirable survival of the fittest, where the driving forces of evolution itself work against the body's design and enforcement of order. In fact, once cancer has begun to develop, this same force continues to drive the progression of cancer towards more invasive stages, and is called clonal evolution.[6] When normal cells are damaged beyond repair, they are eliminated by apoptosis (A). Cancer cells avoid apoptosis and continue to multiply in an unregulated manner (B).
  33. Curing cancer requires eliminating all cancer cells. The major modalities of therapy are Surgery (for local and local-regional disease) Overview of Cancer Therapy Radiation therapy (for local and local-regional disease) Chemotherapy (for systemic disease) Other important methods include Hormonal therapy (for selected cancers, eg, prostate, breast, endometrium) Immunotherapy (monoclonal antibodies, interferons, and other biologic response modifiers and tumor vaccines—see Immunotherapy of Cancer) Differentiating drugs such as retinoids Targeted drugs that exploit the growing knowledge of cellular and molecular biology Modalities of Cancer Therapy : Principles of Cancer Therapy Surgery Primary tumor resection Resection of metastases Cytoreduction Palliative surgery Reconstructive surgery Radiation Therapy Types of radiation therapy Adverse effects Chemotherapy Cytotoxic drugs Hormonal therapy Biologic response modifiers Differentiating drugs Antiangiogenesis drugs Signal transduction inhibitors Monoclonal antibodies Vaccines Multimodality and Adjuvant Chemotherapy Adjuvant therapy Neoadjuvant therapy Bone Marrow/Stem Cell Transplantation Gene Therapy
  34. Defining Response to Cancer Treatment Term Cure Long-term absence of symptoms or signs of a disease, although patients who appear to be cured may still have viable tumor cells that eventually cause relapse Complete remission (complete response) Disappearance of clinical evidence of disease Partial response > 50% reduction in size of tumor mass or masses, sometimes leading to significant palliation and prolongation of life but with inevitable regrowth of the tumor Stable disease Neither improvement nor worsening Disease-free survival (disease-free interval) Interval between disappearance of the tumor and relapse Progression-free survival Time from initiation of treatment to time of overt progression in a surviving patient Survival time Time from diagnosis to death
  35. Pinda – Bamhanda Human being Universe
  36. Dosha Dhatu Mala Mulam
  37. The word agni is Sanskrit for "fire" (noun), cognate with Latin ignis (the root of English ignite), Russian огонь (ogon), Polish "ogień", Slovenian "ogenj", Serbo-Croatian oganj, and Lithuanian ugnis—all with the meaning "fire", with the reconstructed Proto-Indo-European root being h₁égni-. Agni has three forms: fire, lightning and the Sun.[4] In Hindu scriptures, Agni is the God of Fire, and is present in many phases of life such as honouring of a birth (diva lamp), prayers (diva lamp), weddings (Yagna where the bride and groom circle 7 times) and death (cremation).
  38. Vaya Aho – Ratri Bhukta Season Antya Madhya Adi
  39. Vyadhi Utpatti
  40. Kupitanam hi doshanam sharire paridhavatam ..
  41. Vyadhi Utpatti
  42. Vyadhi Utpatti
  43.     According to ayurved, regeneration of cells is carried out by the ‘shukra dhatu’ and is controlled by the ‘vata dosha’. The uncontrolled cell division is a result of imbalance of ‘vata dosha’, which results into neoplasm (The hypothesis of cancer).   As ‘shukra dhatu’ is ‘sarvadehik’, every cell in the body has an inbuilt potential of replication / reproduction, in favorable situations. The ‘akasha’ provides space for accommodation of such multiplying cells (as ‘garbhashaya’ – uterus provides space for growth of embryo). Any space or ‘akasha’ (Kha) is therefore a potential garbhashaya (e.g. test-tube baby). However, if such situation is created in space other than the one designated for the purpose, it is abnormal- ‘Kha-vaigunya’.   Some of the cancerous cells may be carried to such distant places with the circulation, and if they find a suitable place for harboring, they may replicate in that place if the condition is favorable (…Yatra Sanga: Khavaigunyat Vyadhi: tatropjayate). Therefore, a cancer cell can migrate to any place in the body and start multiplying and produce metastatic cancer.   Embryologically, the kidneys are created from the essence of ‘Rakta dhatu’ and ‘Meda dhatu’ (“Rakta Meda Prasadajou Vrukou”). In ayurvedic therapeutics, this reference needs to be viewed in terms of probable mode or route of samprapti (etio-pathology) and its reversal (chikitsa - treatment). Medicines which act on rasa dhatu and meda dhatu would therefore probably be helpful in treating any pathology of Kidney.   In the metastatic bone cancer, ‘Asthi’ predisposed by ‘kha vaigunya’ acts as a site which allows the growth of cells from a distant tissue. This space (kha) also requires special attention while treating metastatic cancer. Therefore, to achieve ‘khavaigunya –less’ perfect asthi dhatu, rasayana treatment (labhopayo hi shastanam rasdinam rasayanam) of ‘ashti’ becomes inevitable.   Asthi dhatu and vata dosha have ‘ashraya- ashrayee’ (interdependent) relationship. ‘Basti’ is an ideal treatment for ‘vata dosha’ related diseases. Therefore, ‘basti’ is an ideal procedure to treat ‘kha vaigunya’ in asthi dhatu. ‘Rajayapana basti’ is a type of ‘basti’ in which a specific formulation, as described in treaties of ayurved, is administered per rectum. It is useful in controlling the cell division.     In the hierarchy of production of dhatu, Asthi dhatu is produced from the Meda dhatu by removing ‘sneha’ from it through process of ‘khara paka’ (Medasa: sneham Aadaya sira snayutvam aapnuyat snayunam ch mridu paka siranam ch tat: khara…) Therfore, rasayana treatment directed at mada dhatu should also benefit as ‘rasayana’ for asthi dhatu.     The herbomineral formulation used internally, is a combination of generic formulations described in ayurvedic treaties. Each of these formulations has a specific role in the management of neoplasm and prevention of its relapse.
  44.     According to ayurved, regeneration of cells is carried out by the ‘shukra dhatu’ and is controlled by the ‘vata dosha’. The uncontrolled cell division is a result of imbalance of ‘vata dosha’, which results into neoplasm (The hypothesis of cancer).   As ‘shukra dhatu’ is ‘sarvadehik’, every cell in the body has an inbuilt potential of replication / reproduction, in favorable situations. The ‘akasha’ provides space for accommodation of such multiplying cells (as ‘garbhashaya’ – uterus provides space for growth of embryo). Any space or ‘akasha’ (Kha) is therefore a potential garbhashaya (e.g. test-tube baby). However, if such situation is created in space other than the one designated for the purpose, it is abnormal- ‘Kha-vaigunya’.   Some of the cancerous cells may be carried to such distant places with the circulation, and if they find a suitable place for harboring, they may replicate in that place if the condition is favorable (…Yatra Sanga: Khavaigunyat Vyadhi: tatropjayate). Therefore, a cancer cell can migrate to any place in the body and start multiplying and produce metastatic cancer.   Embryologically, the kidneys are created from the essence of ‘Rakta dhatu’ and ‘Meda dhatu’ (“Rakta Meda Prasadajou Vrukou”). In ayurvedic therapeutics, this reference needs to be viewed in terms of probable mode or route of samprapti (etio-pathology) and its reversal (chikitsa - treatment). Medicines which act on rasa dhatu and meda dhatu would therefore probably be helpful in treating any pathology of Kidney.   In the metastatic bone cancer, ‘Asthi’ predisposed by ‘kha vaigunya’ acts as a site which allows the growth of cells from a distant tissue. This space (kha) also requires special attention while treating metastatic cancer. Therefore, to achieve ‘khavaigunya –less’ perfect asthi dhatu, rasayana treatment (labhopayo hi shastanam rasdinam rasayanam) of ‘ashti’ becomes inevitable.   Asthi dhatu and vata dosha have ‘ashraya- ashrayee’ (interdependent) relationship. ‘Basti’ is an ideal treatment for ‘vata dosha’ related diseases. Therefore, ‘basti’ is an ideal procedure to treat ‘kha vaigunya’ in asthi dhatu. ‘Rajayapana basti’ is a type of ‘basti’ in which a specific formulation, as described in treaties of ayurved, is administered per rectum. It is useful in controlling the cell division.     In the hierarchy of production of dhatu, Asthi dhatu is produced from the Meda dhatu by removing ‘sneha’ from it through process of ‘khara paka’ (Medasa: sneham Aadaya sira snayutvam aapnuyat snayunam ch mridu paka siranam ch tat: khara…) Therfore, rasayana treatment directed at mada dhatu should also benefit as ‘rasayana’ for asthi dhatu.     The herbomineral formulation used internally, is a combination of generic formulations described in ayurvedic treaties. Each of these formulations has a specific role in the management of neoplasm and prevention of its relapse.
  45. Kupitanam hi doshanam sharire paridhavatam .. Not to allow vitiation Not to allow spread Not to allow dosha-dusha samurchana
  46. inherent Bala Kapha moolam balam General Specific Sahaja – Innate Kalaj – Yuktikruta – Acquired
  47. Bala Kapha moolam balam Sahaja – Innate Kalaj – Yuktikruta – Acquired
  48. Madhura Amla Lavana
  49. Shamana Medicines that reduces increased dosha without interfering with normal dosha Shodhana
  50. Rasa Vipaka G Veerya Vipaka
  51. Absolute bruhana Relative bruhana Absolute langhana
  52.     According to ayurved, regeneration of cells is carried out by the ‘shukra dhatu’ and is controlled by the ‘vata dosha’. The uncontrolled cell division is a result of imbalance of ‘vata dosha’, which results into neoplasm (The hypothesis of cancer).   As ‘shukra dhatu’ is ‘sarvadehik’, every cell in the body has an inbuilt potential of replication / reproduction, in favorable situations. The ‘akasha’ provides space for accommodation of such multiplying cells (as ‘garbhashaya’ – uterus provides space for growth of embryo). Any space or ‘akasha’ (Kha) is therefore a potential garbhashaya (e.g. test-tube baby). However, if such situation is created in space other than the one designated for the purpose, it is abnormal- ‘Kha-vaigunya’.   Some of the cancerous cells may be carried to such distant places with the circulation, and if they find a suitable place for harboring, they may replicate in that place if the condition is favorable (…Yatra Sanga: Khavaigunyat Vyadhi: tatropjayate). Therefore, a cancer cell can migrate to any place in the body and start multiplying and produce metastatic cancer.   Embryologically, the kidneys are created from the essence of ‘Rakta dhatu’ and ‘Meda dhatu’ (“Rakta Meda Prasadajou Vrukou”). In ayurvedic therapeutics, this reference needs to be viewed in terms of probable mode or route of samprapti (etio-pathology) and its reversal (chikitsa - treatment). Medicines which act on rasa dhatu and meda dhatu would therefore probably be helpful in treating any pathology of Kidney.   In the metastatic bone cancer, ‘Asthi’ predisposed by ‘kha vaigunya’ acts as a site which allows the growth of cells from a distant tissue. This space (kha) also requires special attention while treating metastatic cancer. Therefore, to achieve ‘khavaigunya –less’ perfect asthi dhatu, rasayana treatment (labhopayo hi shastanam rasdinam rasayanam) of ‘ashti’ becomes inevitable.   Asthi dhatu and vata dosha have ‘ashraya- ashrayee’ (interdependent) relationship. ‘Basti’ is an ideal treatment for ‘vata dosha’ related diseases. Therefore, ‘basti’ is an ideal procedure to treat ‘kha vaigunya’ in asthi dhatu. ‘Rajayapana basti’ is a type of ‘basti’ in which a specific formulation, as described in treaties of ayurved, is administered per rectum. It is useful in controlling the cell division.     In the hierarchy of production of dhatu, Asthi dhatu is produced from the Meda dhatu by removing ‘sneha’ from it through process of ‘khara paka’ (Medasa: sneham Aadaya sira snayutvam aapnuyat snayunam ch mridu paka siranam ch tat: khara…) Therfore, rasayana treatment directed at mada dhatu should also benefit as ‘rasayana’ for asthi dhatu.     The herbomineral formulation used internally, is a combination of generic formulations described in ayurvedic treaties. Each of these formulations has a specific role in the management of neoplasm and prevention of its relapse.
  53. Shodhana of Dosha No Shodhana of Dhatu
  54. Shodhana of Dosha No Shodhana of Dhatu
  55. Sitopaladi Churna Hirak Bhasma Abhrak bhasma Suvarna bhasma Rajata bhasma Tamra bhasma Bruhatvata chintamani rasa Makardhwaja rasa Sheelajeet
  56. Sitopaladi Churna Hirak Bhasma Abhrak bhasma Suvarna bhasma Rajata bhasma Tamra bhasma Bruhatvata chintamani rasa Makardhwaja rasa Sheelajeet
  57. Tamra bham: Tikta, Kahay, Madhur, Ushnaveerya, Vishahara, sarak, laghu, tridhsha hara, anti-obesity, Yakrut-plihodara, 1/8 to ½ ratti
  58. Sitopaladi Churna Hirak Bhasma Abhrak bhasma Suvarna bhasma Rajata bhasma Tamra bhasma Bruhatvata chintamani rasa Makardhwaja rasa Sheelajeet
  59.     According to ayurved, regeneration of cells is carried out by the ‘shukra dhatu’ and is controlled by the ‘vata dosha’. The uncontrolled cell division is a result of imbalance of ‘vata dosha’, which results into neoplasm (The hypothesis of cancer). In the metastatic bone cancer, ‘Asthi’ predisposed by ‘kha vaigunya’ acts as a site which allows the growth of cells from a distant tissue. This space (kha) also requires special attention while treating metastatic cancer. Therefore, to achieve ‘khavaigunya –less’ perfect asthi dhatu, rasayana treatment (labhopayo hi shastanam rasdinam rasayanam) of ‘ashti’ becomes inevitable.   Asthi dhatu and vata dosha have ‘ashraya- ashrayee’ (interdependent) relationship. ‘Basti’ is an ideal treatment for ‘vata dosha’ related diseases. Therefore, ‘basti’ is an ideal procedure to treat ‘kha vaigunya’ in asthi dhatu. ‘Rajayapana basti’ is a type of ‘basti’ in which a specific formulation, as described in treaties of ayurved, is administered per rectum. It is useful in controlling the cell division.     In the hierarchy of production of dhatu, Asthi dhatu is produced from the Meda dhatu by removing ‘sneha’ from it through process of ‘khara paka’ (Medasa: sneham Aadaya sira snayutvam aapnuyat snayunam ch mridu paka siranam ch tat: khara…) Therfore, rasayana treatment directed at mada dhatu should also benefit as ‘rasayana’ for asthi dhatu.     The herbomineral formulation used internally, is a combination of generic formulations described in ayurvedic treaties. Each of these formulations has a specific role in the management of neoplasm and prevention of its relapse.