An Ordinary Practitioner’s Moxibustion for Cancer Patients

An Ordinary Practitioner’s Moxibustion for Cancer Patients

by Fukushima Tetsuya

This article was first published by the North America Journal of Oriental Medicine, NAJOM, July 2018; 3-4 and is republished here with permission

In the “Comprehensive Discourse on Regulating the Spirit in Accordance with the Qi of the Four Seasons” (Siqi Tiaoshen Dalunpian of the Suwen), it says, “The sages did not treat those already ill, but treated those not yet ill. They did not put in order what was already in disorder but put in order what was not yet in disorder. When drugs are employed for therapy only after a disease has become fully developed. When restoring order is initiated only after a disorder has fully developed, this is as if a well were dug when one is thirsty, and as if weapons were cast when the fight is on. Would this not be too late?” Patients afflicted with cancer are people experiencing disease not in the “not yet ill” stage but rather in the “fully developed” (and probably final) stage.

As an ordinary practitioner, to date I have never administered treatment with the goal of eliminating or reducing cancer, nor have I even once been involved in such a case. However, I have administered moxibustion treatment for symptoms associated with cancer (such as pain, edema, and anxiety) and various conditions of poor health or general malaise (including dizziness, nausea, poor appetite, and low energy) resulting from the effects of anti-cancer medication and radiation therapy, with the expectation of improvement in these symptoms and stimulation of immunity. Of these cases, I will present a few that stand out in my memory.

Moxibustion on the Navel

Ren 8 is the acupoint located at the navel and is contraindicated for moxibustion in ancient texts. I believe it is often used for warming moxibustion (such as with salt moxibustion) and indirect moxibustion. Or, moxibustion surrounding the navel (extra points Qizhongsibian) is used instead. I also do not typically apply direct moxibustion at the navel, but in two cases I experienced dramatic results by trying small moxa cones at the navel on late-term cancer patients with ascites or generalized edema. One was a hospitalized patient whom I treated once a week for the first through third treatments with an approach using a noninvasive acupuncture implement, and multiple cones of moxibustion on Shimian, a well-known moxibustion point for treating edema. But this did not bring about much change in the edema. Coincidentally, the patient received an odd authorization from her doctor to receive moxibustion as much as she wanted if she so desired, so I tried just 7 small grains of direct moxa on Ren 8. Then from that evening on, her urination volume increased, the ascites decreased and she felt better. Subsequently, I performed a similar treatment two more times, but about one month later the patient passed away.

Another case was of a patient receiving at-home care. Starting with the first treatment, the jing-well points on all 10 fingers were bled, and 7 small cones of moxibustion were used each on Ren-8 and ST-36. Moxibustion was not performed on Shimian. Over three courses of treatment at a frequency of two treatments per week, the generalized edema decreased gradually, however soon afterwards the patient’s condition took a sudden turn for the worse, and after undergoing emergency hospitalization the patient passed away.

For Strong Tonification

For coldness in the abdomen and lumbar regions, I take my time and often gradually add warming stimulation. Incidentally, the acupoint Ren-4 is one that I will basically always check for a response during an abdominal diagnosis, and as I use it so frequently it is a strong contender for being my favorite acupoint. It is the front-mu point of the small intestine channel, and in the Mubun-style dashin technique, Ren-4 is needled first in the hibiki-no-hari style. As for the response on the body surface, it often presents not as hardness but rather slightly depressed visually and tactilely.

For patients who present with coldness here, I will use warming stimulation with a moxa stick and treat it while envisioning the gradual transmission of warming energy into a large hole. With direct moxibustion, I will often use numerous cones on Ren-4, and for health preservation moxibustion that can be performed at home, I often recommend it as one of a set of acupoints. For cancer patients who have experienced a significant decrease in strength, I have used ball moxibustion on the lower abdomen (near Ren-4) and lumbar region (near UB-23) where the area presents with weakness and concavity.

As for the moxibustion technique, a moist towel is placed over the skin and newspaper laid over that, on top of which is placed a tennis ball-sized or golf ball-sized moxa ball (that has already been lit into a ball of fire). When the patient senses heat, the entire setup including the towel is moved. Incidentally, ball moxibustion is regarded as a strongly tonifying moxibustion technique used in conditions of extreme weakness and deficiency.

Because I am currently treating patients in an environment where it is not possible to create large amounts of smoke, I either use smokeless moxa sticks with a holder or a hot water bottle. However if smoke is not an issue, ball moxibustion is an effective technique for strong notification. 

Moxibustion Points for Breast Cancer

In the chapter “Breast Cancer of Meika Kyusen Sanhen” (Selected Moxibustion Points of Famous Practitioners, 3rd Volume), there are two acupoints mentioned for moxibustion treatment of breast cancer, as described below. I think this is worth trying if the opportunity presents itself.

1. Method for patients with breast nodule or breast cancer:
   Shiko method: Perform moxibustion on ST-36. Start with 7 cones, then continue daily with 3 cones.
2. Method for all types of breast disease, such as acute mastitis, breast nodule, breast abscess, and breast cancer:
   Ishihara method: First, find UB-43, then go diagonally in the medial direction about 1 cun where the fingertip finds a depression. If this point is extremely sensitive, this is an acupoint. Perform moxibustion on the left side for a person who has a problem on the left side, and vice versa.

In description 1, the acupoint used is ST-36, and there is mention of the number of cones used (7 cones on the first day and then 3 cones every day thereafter). As for the basis of this point selection according to meridian flow, it may be because the nipple and ST-36 are both located on the foot yang ming channel. The latter is the ashi point associated with UB-43 (with the pathological side being treated). The description says to locate the acupoint after confirming the condition of the location (depression at the fingertip) and ashi point response (extreme pain upon pressure), but there is no mention on the number of cones. For the area near UB-43, multiple cone moxibustion is often administered, but for cancer patients whose energy levels have dropped off, I recommend starting off with a smaller number of cones and observing the response.

Small Scarring Moxibustion

Although scarring moxibustion is no longer practiced much, apparently up to a few decades ago it was still used as a final option in treating cancer. Incidentally, in the journal Ido No Nippon (March 2007 issue), a case study is presented on scarring moxibustion by Kunihiro Hamazoe (titled “I want to tell you about this memorable case study! Scarring moxibustion used to stop pain from late-stage maxillary sinus cancer”). Also, in September of last year (2017) when I was attending a moxibustion festival (5th International Moxibustion Technique Conference) held in Hangzhou,
China, I came across photos of huge moxa scars, the size of which would not be believed in Japan.

They are from the book Fuyang Huanong Jiufa (Fuyang Pus Producing Moxibustion Technique) by Wang Yanfeng, a practitioner of heat penetration moxibustion therapy who took the stage as a leading figure in the moxibustion community. I encourage those interested to reference this book.

I myself have never received large scarring moxibustion nor treated a patient with this technique as is performed at Yotsugi Moxibustion (Yotsugi no Kyu), but I do perform small scarring moxibustion on myself (between the size of a soybean and the tip of the pinky finger) a few times a year as the ultimate detox for maintaining health. To explain the technique simply, the first 2 to 3 cones are about the size of a grain of rice and the heat is mitigated with a bamboo tube. After this, about 1 to 2 cones the size of a soybean (or pinky fingertip) are added. More so than feeling hot, the sensation at this time is one of feeling strongly pressed, and most people are able to endure it. The ashes are then removed and munikou salve rubbed on the moxa scar, and above this a paper bandage is applied. A few days later the scar will begin to discharge pus, so a new bandage is reapplied once or twice a day.

For a handful of lung cancer patients, I have tried using the small scarring moxibustion technique on Sihua and Huanmen (point locations described below) for the purpose of easing back pain, but while over half derived satisfactory benefits, because of the inconvenience of having family members reapply the salve, almost all discontinued treatment. Based on this lesson, subsequently, I decided to only treat ST-36 for the purpose of activating immunity.

Point Locations: Sihua and Huanmen

Sihua point location

1. First, place a string around the patient’s neck and then adjust and cut it so that both ends lie at Ren-15.
2. Place the midpoint of the string on the patient’s Adam’s apple, and bring the ends of the string to the patient’s backside so that they meet on the Du meridian. This is the tentative point location.
3. Measure the width of the patient’s mouth with a separate piece of string, and cut the string to this length. 

Actually, the following methods for point location by Zhang Jieshi and Cui Zhiti are slightly different.

A. Zhang Jieshi Method (Diamond shape Sihua)

Take the string used to measure the patient’s mouth width and place its midpoint on the tentative point located on the Du meridian (determined with the other string according to the procedure described above using Ren-15). The ends of the string stretched horizontally define two acupoints, and the ends of the same string stretched vertically define two other acupoints (on the Du meridian) for a total of four acupoints.

B. Cui Zhiti Method (Square Sihua)

Make a square out of a piece of paper with each side the same length as the string used to measure the patient’s mouth width (described in step 3 above). Make a hole in the center of the paper, then place the hole on the tentative acupoint on the Du meridian (described in step 2 above). The four corners of the paper define the four acupoints of Sihua.

Huanmen point location

1. Place one end of a string at the tip of the patient’s large toe, and then extend the string so that it runs under the sole of the foot, over the center of the heel, and up to UB-40 behind the knee.
2. Using this string length, start at the patient’s nose tip and extend the string up the midline of the head and back down behind the head so that the end lies along the Du meridian. The end point defines the tentative acupoint (but is not the location where moxibustion is administered).
3. With another piece of string, start at one corner of the patient’s mouth and trace the string under the nose to the other mouth corner, and then cut the string. (In the clinic, I often use a setsquare triangle instead of string.)
4. Place the midpoint of this string at the previously designated tentative acupoint and extend the string horizontally. The location of the two ends
   are two acupoints.

This article has devolved into somewhat rambling miscellany, but if the humble experiences of an ordinary practitioner can be of clinical reference for even a few people, I will have considered it worthwhile.

                                        Translated by Eugene Iwasa

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