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Tiffany Chiu Cat Calhoun George Tabares Leah Shadwick Slide 2 Slide 3 Breast Cancer: Abnormal cells in the breast Risk Factors Heredity Lifestyle Obesity Child bearing before age 20 or after 35 Environmental Increased Estrogen Early menarche Late menopause Oral OCP before age 20 HRT for over 10 years Types In Situ Carcinoma entirely contained in the breast Ductual Carcinoma Makes up 43% of breast cancers Peri/post menopausal Lobular Carcinoma Contained in breast No mass Usually found by accident Inflammatory Carcinoma Most aggressive form Peau dorange: brast resembles orange peel texture Slide 4 Biomedicine Diagnosis Mammogram Ultrasound Biopsy Treatment Lumpectomy Remove partial breast Mastectomy Remove whole breast Radiation High energy x-rays to destroy cancer cells after lumpectomy Chemotherapy Cancer fighting drugs Hormone Therapy Block effect of estrogen Slide 5 Traditional Chinese Medicine Diagnosis Qi Stagnation Blood Stasis Phlegm Retention Toxic Heat Treatment- Herbs Shi Quan Da Bu Tang Jia Jian Increases white blood cell Er Xian Tang Tonifies KD yang, tonifies yin, nourish jing/essence, regulates chong/ren Xiao Yao San Resolve Phlegm/lumps, dredge LV channel, Regulate Qi, Xiang Sha Liu Jun Zi Tang Jia Jian Tonify SP, Resolve phlegm/lumps, soften hardness Liu Wei Di Huang Wan Harmonize Chong/Ren, Tonify KD, Nourish LV Tao Hong Si Wu Tang Jin Yin Hua Cao Tang Jia Jian Blood stasis, Clear heat, relieve Toxicity, dissipate lumps Slide 6 Benign Ovarian Cysts Slide 7 Defined as: Fluid-filled sacs or pockets within or on the surface of an ovary that are greater than 2cm in diameter. Odds that your female patients will develop ovarian cysts? Premenopausal women: Postmenopausal women: 97% 14% Primary complaints/symptoms: Lower abdominal pain, heaviness, painful or difficult sexual intercourse, and abnormal menstrual bleeding. Even after resolution, recurrence is common. Slide 8 Benign Ovarian Cysts Types Functional Cysts Occur during the the menstrual cycle as a result of hormone imbalance during the cycle. Possible complications: rupture, hemorrhage, twisting of the ovary due to weight and size of cyst leading to lack of blood supply and eventual tissue necrosis. Abnormal Cysts Are the result of abnormal cell growth Slide 9 Benign Ovarian Cysts Types (contd) Abnormal Cysts Occur from abnormal cell growth rather than during the course of the menstrual cycle. While functional cysts may resolve without intervention, these will not. Cystadenoma Endometrial/chocolate Cyst Dermoid/teratoma Cyst Slide 10 Benign Ovarian Cysts Herbal TCM Treatment Soften Masses For all cysts which form abdominal masses, soften the masses. Softening herbs can be added to all representative formulas below. These herbs include, but are not limited to: Yi yi ren, hai zao, gui ban, wa leng zi, xia ku cao, kun bu, etc. Liver Qi Stagnation Chai Hu Shu Gan San or Xiao Yao San Qi and Blood Stagnation Jin Ling Zi San + Shi Xiao San, Da Qi Qi Tang Blood Stasis Ge Xia Zhu Yu Tang, modified with san leng, ze lan and/or e zhu. Qi Xu and Blood Stasis Ba Zhen Tang, modified with to include blood stasis and soften masses herbs Kidney Yang Xu + damp/phlegm Yu She Wen Bu Fang Slide 11 Slide 12 Endometriosis Symptoms Chronic Pelvic Pain Dysmenorrhea Irregular Menses Dyspareunia GI problems Bladder problems Lumbago Infertility Allergies Fatigue Theory Sampsons retrograde theory Coelomic metaplasia: peritoneal tissue transforms Inflammation Iatrogenic origin Environmental toxins Lymphatics Hypo & hyper immune function. Genetic factors Abdominal wall/pelvic floor dysfunction Biomedicine Endometriosis is a complicated disease that affects an estimated 6 million women and girls in the US. Defined by the presence of endometrial cells outside of the uterus. Slide 13 Biomedicine Diagnosis Hormone tests MRI Hysteroscopy Laparoscopy Reproductive Immunophenol Panel (RIT) Treatment Drugs: Danazol, Aromatase Inhibitor, Birth Control Surgery: salpingo- oopherectomy Pregnancy Prevention Health screening (Family history) Slide 14 TCM In TCM signs and symptoms are a combination of disease categories within Chinese medicine Theory Surgery creates xue yu and yu xue 7 Emotions: anger, mania, pensiveness, grief & sadness, fear & fright Cold Uterus Diagnosis Qi Yu Xue Yu Yu Xue Re (Li; LV, HT, ST) Xu (SP, KI, LV Xue, HT Xue) Slide 15 TCM Treatment Acupuncture Herbal Formulas oShao Fu Zhu Yu Tang Drive Out Stasis in the Mansion of Blood Decoction oJia Wei Xiao Yao San Augmented Rambling Powder oTao He Cheng Qi Tang Peach Pit Decoction to Order the Qi oGui Shen Wan Restoring the Kidneys Decoction oGui Pi Tang Return the Spleen Decoction Prevention Lifestyle oDiet oExercise oStress Reduction oMeditation Slide 16 Amenorrhea Slide 17 Biomedicine Primary Amenorrhea Primary Amenorrhea absence of menstruation without previously established cycles absence of menstruation without previously established cycles Causes Causes Chromosomal Abnormalities Chromosomal Abnormalities Hypothalamus Problems Hypothalamus Problems Pituitary Disease Pituitary Disease Hyperandrogenism Hyperandrogenism Lack of reproductive organs Lack of reproductive organs Structural vagina abnormality Structural vagina abnormality Hypothyroidism HypothyroidismTreatment Surgery Surgery Hormone Replacement Hormone Replacement Secondary Amenorrhea Secondary Amenorrhea absence of menses for six months after the start of menarche Causes Pregnancy Pregnancy Contraceptives Contraceptives Breast-Feeding Breast-Feeding Stress Stress Hormonal Imbalance Hormonal Imbalance Low body weight Low body weight Excess Exercise Excess Exercise Thyroid disease Thyroid disease Pituitary tumor Pituitary tumor Uterine Scarring Uterine Scarring Primary Ovarian Insufficiency Primary Ovarian InsufficiencyTreatment Stress Reduction Stress Reduction Dietary and lifestyle changes Dietary and lifestyle changes Hormone Replacement Hormone Replacement Slide 18 Traditional Chinese Medicine Diagnosis 1. Liver Blood Deficiency 2. Spleen and Kidney Yang Deficiency 3. Liver and Kidney Yin Deficiency 4. Lung Yin and Blood Deficiency 5. Heart and Kidney Yin Deficiency 6. Heart and Spleen Blood Deficiency 7. Stagnation of Qi and Blood 8. Damp Phlegm in uterus Herbal Treatment 1. Ba Zhen Tang 2. Fu Ke Zhu Xian Dan 3. Zuo Gui Yin plus Si Wu Tang 4. Bai He Gui Jin Tang variation 5. Tian Wang Bu Xin Dan 6. Gui Pi Tang 7. Tao Hong Si Wu Tang 8. Cang Fu Dao Tan Wan plus Fo Shou San variation