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Celostno zdravljenje raka z akupunkturo v Sloveniji

Slovenija je po obolevnosti in umrljivosti za rakom med evropskimi državami pri vrhu. Pet najpogostejših vrst raka pri nas, ki obsegajo skoraj 60 % vseh novih primerov rakavih bolezni, so: kožni rak (brez melanoma), rak prostate, raki debelega črevesa in danke, rak dojke in rak pljuč. [1]

Konvencionalno zdravljenje raka

Po navadi je rak diagnosticiran s konvencionalno medicino ter tako tudi obravnavan. Pod obravnavo spadajo: operacija, kemoterapija, obsevanje, hormonska terapija, ciljno zdravljenje. Bolniki lahko prejmejo tudi podporno zdravljenje za odpravljanje neželenih učinkov.

Zdravljenje raka lahko zelo pogosto povzroči številne neželene učinke. Neželeni učinek se pojavi, kadar zdravljenje poškoduje zdrave celice ali kadar so med operacijo odstranjeni organi. Neželeni učinki so lahko pri vsaki osebi različni, na primer: utrujenost, bolečine, slabost/bruhanje, izpadanje las, spremembe na koži, pomanjkanje apetita, razjede v ustih, driska, zaprtje, učinki na živčni sistem itd.

Komplementarno zdravljenje rakavih obolenj

Najprej poudarimo razliko med alternativnim (nadomestnim) in komplementarnim (dopolnilnim zdravljenjem). Alternativno zdravljenje se uporablja namesto standardnega zdravljenja. Tovrstna oblika je po navadi odsvetovana. Po drugi strani pa dopolnilno zdravljenje dopolnjuje medicinske metode zdravljenja in je dodatek k osnovnemu zdravljenju raka. Pomaga lajšati simptome, stranske učinke zdravljenja in lahko izboljša kakovost življenja.

V sodobni onkologiji ni več pomembno zgolj preživetje bolnikov, temveč tudi kakovost njihovega življenja. Le-to lahko bistveno izboljšamo z izvajanjem celostne onkološke rehabilitacije. Postopki za komplementarno zdravljenje raka običajno niso namenjeni odpravi rakavih obolenj, temveč predvsem lajšanju simptomov in lažjemu spopadanju z učinki klasičnega zdravljenja. Komplementarno zdravljenje raka pomaga blažiti negativne posledice kemoterapije, kot sta utrujenost in slabost, krepi imunski sistem ter pomaga lajšati stres. [2]

Med komplementarne metode zdravljenja spadajo [3]: 

  1. Tradicionalni medicinski sistemi Ti so tesno povezani s filozofsko predstavo o svetu in človeku v njem. Mednje uvrščamo tradicionalno kitajsko medicino (TKM), tradicionalno indijsko medicino ali ayurvedo, homeopatijo in naturopatijo.

  2. Tehnike sproščanja in terapije z vajami Te prakse uporabljajo različne tehnike, s katerimi s pomočjo misli (uma) vplivamo na telesne funkcije in simptome. To so meditacijske in dihalne tehnike, različni stili joge, globoka relaksacija, taj či, ustvarjalno izražanje (umetnost, glasbena terapija, ples).

  3. Manipulativne in telesne tehnike Te poskušajo z manipulacijo (premikanje enega ali več delov telesa v zdravilne položaje) popraviti neravnovesje. Znane so Aleksandrova tehnika, osteopatija, kiropraktika, različne masaže in refleksologija.

  4. Biološko utemeljene terapije Te uporabljajo naravne proizvode – zdravilne snovi kot so zelišča, minerali, vitamini in prehranski dodatki.

  5. Bioenergijske terapije Vključujejo uporabo energetskih polj. Ločijo se na bioenergetske terapije: či gong, reiki, terapevtski dotik; in bioelektromagnetske terapije: magnetna ali svetlobna terapija.

TKM in akupunktura za zdravljenje rakavih obolenj

Kitajska medicina se izvaja že 3.000 let ali več. Lao Li Xing, direktor šole kitajske medicine na Univerzi v Hongkongu, meni, da lahko ta starodavna praksa zapolni vrzeli in odpravi nekatere omejitve zahodne medicine, kot so rak in stranski učinki zdravljenja. Radioterapija in kemoterapija sta ključnega pomena, vendar imata pogosto problematične stranske učinke: nespečnost, slabost, bruhanje, včasih suha usta zaradi radioterapije. Kitajska medicina ima lahko veliko vlogo pri izboljšanju kakovosti življenja bolnikov. Tako zahodna kot kitajska medicina bosta skupaj poskrbeli, da bo bolnik spet dobrega zdravja. [4]

Vrednost kitajske medicine je v njenih različnih načinih diagnosticiranja in ukrepanja, ki poudarjajo negovanje zdravja, preprečevanje bolezni, zaščito zmogljivosti v zdravju in bolezni ter funkcionalno usmerjeno dobro počutje človeka kot celote. Kitajska medicina pogosto ponuja alternativne rešitve tam, kjer konvencionalna medicina odpove. Tako povezovanje modrosti in pristopov kitajske in konvencionalne medicine predstavlja bližnjico za zadovoljitev številnih neizpolnjenih zdravstvenih potreb. Medtem ko zahodni zdravnik raziskuje, kaj se dogaja v telesu, zdravnik kitajske medicine pogojuje telo kot celoto in pri tem ne vidi, kaj konkretno povzroča težavo - kar poudarja potrebo po kombinaciji in ne zgolj po kitajskih zdravilih. [4]

Nekaj študij je preučilo kompleksnost odnosa, izkušenj, ovir in dojemanja preživelih bolnic z rakom dojke pri uporabi TKM kot dela zdravljenja. Udeleženke so uporabljale TKM kot obliko samopomoči in kot dopolnitev standardne oskrbe. Akupunkturo je uporabljalo 100 % udeleženk, 62 % kitajsko zeliščno medicino, 23 % qigong in 23 % kitajsko prehransko terapijo. Udeleženci so poročali o zaznanih rezultatih in koristih za zdravje zaradi uporabe TKM: od izboljšanja mehanizmov spoprijemanja, lajšanja stresa in stranskih učinkov standardnega zdravljenja, želje po proaktivni udeležbi pri zdravljenju in vzpostavitvi nadzora. Nekateri so navedli, da sta pomembna potreba po "odmoru" in terapevtski odnos z zdravnikom TKM. [5]

Akupunktura za zdravljenje rakavih obolenj v Sloveniji

Akupunktura je danes uveljavljena in vedno pogosteje uporabljena komplementarna metoda. Uporablja se jo za lajšanje bolečinskih sindromov, ki so posledica zdravljenja (operacija, kemoterapija, obsevanje). Učinkovita je pri kronični nevropatski bolečini, ki je odporna na zdravljenje z zdravili, zmanjševanju slabosti in bruhanja ob kemoterapiji in obsevanju, ter pri prezgodnji menopavzi pri raku dojk in z njo povezanih težavah, kot so vročinski oblivi, katerim se lahko pridružijo še palpitacije, nespečnost, motnje razpoloženja in depresija. [6]

Akupunktura je že od konca šestdesetih in začetka sedemdesetih let uradna metoda zahodne medicine ter je, po pojasnilih Zavoda za zdravstveno zavarovanje Slovenije, mogoča na napotnico kot metoda protibolečinskega zdravljenja. Napotnico lahko izda osebni zdravnik ali pooblaščeni specialist, če meni, da bolnik to zdravljenje potrebuje. Protibolečinsko zdravljenje z akupunkturo v okviru obveznega zdravstvenega zavarovanja je dovoljeno pri tistih bolezenskih stanjih, ki so posledica obolenja ali poškodbe mišičnoskeletnega ali živčnega sistema. [7, 8] [Preberi več: Akupunktura učinkovita pri kroničnih mišičnoskeletnih bolečinah pri prebolelih za rakom]

Akupunkturo na napotnico izvajajo anesteziologi z dodatnim strokovnim znanjem na tem področju v protibolečinski ambulanti (t.i. zahodna akupunktura). Obstajata dve vrsti akupunkture. Ena je klasična kitajska, ki temelji na osnovah izpred dva tisoč let, druga je bolj zahodna. Za razliko od TKM, ki pacienta obravnava holistično, zahodna akupunktura kombinira in uporablja nek izbor točk, ki so primerne za zdravljenje določenih bolezni. [8]

Akupunkturo za bolnice z rakom dojk izvajajo tudi na Onkološkem inštitutu v okviru protibolečinske ambulante. Letno z obravnavajo 120 bolnic, kolikor dopuščajo zmogljivosti [6].  V pilotni raziskavi OREH (O – onkološka, REH – rehabilitacija), ki je potekala na Onkološkem inštitutu Ljubljana od leta 2019 do 2022, so pri 600 bolnicah z rakom dojk izvedli celostno onkološko rehabilitacijo. Zaključki pilotne raziskave OREH kažejo, da so imele bolnice, ki so bile deležne celostne rehabilitacije, večjo kakovost življenja, manj težav in neželenih učinkov zdravljenja, krajšo bolniško odsotnost in manj invalidskega upokojevanja. Bolnice so bile v okviru raziskave napotene na obravnavo na: Oddelku za psihoonkologijo onkološkega inštituta (OI), obravnavo v Enoti za klinično prehrano OI, fizioterapijo v okviru OI, obravnavo zaradi bolečin in vročinskih valov v Protibolečinsko ambulanto v okviru OI, na obravnavo v Ginekološko ambulanto OI, na poklicno rehabilitacijo na URI SOČA, fizikalno rehabilitacijo na Inštitut medicinske rehabilitacije na UKC Ljubljana, pogovor k družinskemu zdravniku in na delavnice v okviru Centrov za krepitev zdravja. Zaradi dolgih čakalnih dob za nekatere obravnave v Sloveniji, kot sta akupunktura ali kognitivno-vedenjska terapija, nekatere bolnice zdravljenja niso prejele takoj oziroma takrat, ko so ga najbolj potrebovale. Povprečna čakalna doba za akupunkturo znaša namreč 120 dni. [9]

Rak je nepredvidljiva bolezen, ki nam življenje obrne na glavo ter v kombinaciji z zdravljenjem lahko v našem telesu povzroči pravi kaos. Čudežno zdravilo proti raku žal ne obstaja. Vendar se telo, ki je umirjeno, spočito in nahranjeno s potrebnimi hranilnimi snovmi, lažje bori proti vsemu, kar prinaša rak. Zato so dopolnilne terapije, kot sta TKM in akupunktura, odličen način za pomoč konvencionalni medicini in zagotavljanje najboljših možnosti za ozdravitev. Za več informacij in prilagojen načrt zdravljenja se posvetujte z zdravnikom TKM.


Viri:

 

Acupuncture for Holistic Cancer Treatment in Slovenia

Slovenia is among the top European countries in terms of cancer incidence and mortality. The five most common cancers in Slovenia, which account for almost 60% of all new cancer cases, are skin cancer (non-melanoma), prostate cancer, colorectal cancer, breast cancer, and lung cancer. [1]

Conventional Cancer Treatment 

Cancer is usually diagnosed and treated using conventional medicine. Treatment may include surgery, chemotherapy, radiation, hormonal therapy, targeted therapies. Patients may also be given supportive treatments to treat side effects.

Very often cancer treatments may cause many side effects. A side effect occurs when treatment damages healthy cells, or organs are removed during surgery. Side effects can be different for each person, such as fatigue, pain, nausea/vomiting, hair loss, skin changes, lack of appetite, mouth sores, diarrhea, constipation, nervous system effects, etc. 

Complementary Cancer Treatment

First of all, let us stress the difference between alternative and complementary treatment. Alternative treatment is used instead of standard treatments. This type of treatment is usually discouraged. On the other hand, complementary treatment complements medical treatment methods and is an addition to the basic treatment of cancer. It helps to relieve symptoms, side effects of treatment and can improve quality of life.

In modern oncology, it is no longer just the survival of patients that is important, but also their quality of life. This can be significantly improved by implementing integrated oncological rehabilitation. Complementary cancer therapies are usually not aimed at eliminating the cancer, but rather at relieving symptoms and making it easier to cope with the effects of conventional treatments. Complementary cancer therapies help to alleviate the negative effects of chemotherapy, such as fatigue and nausea, strengthen the immune system, and help relieve stress. [2]

Complementary treatments include [3]: 

  1. Traditional medical systems These are closely linked to a philosophical view of the world and the human being in it. These include Traditional Chinese Medicine (TCM), Traditional Indian Medicine or Ayurveda, homeopathy, and naturopathy.

  2. Relaxation techniques and exercise therapies These practices use a variety of techniques to influence bodily functions and symptoms through the mind. Meditation and breathing techniques, different styles of yoga, deep relaxation, Tai Chi, and creative expression (art, music therapy, dance).

  3. Manipulative and bodywork techniques They try to correct the imbalance by manipulation (moving one or more parts of the body into healing positions). Well-known are the Alexander Technique, osteopathy, chiropractic, various massages, and reflexology.

  4. Biologically based therapies These use natural products - healing substances such as herbs, minerals, vitamins, and nutritional supplements.

  5. Bioenergy therapies These involve the use of energy fields. They are divided into bioenergetic therapies: qi gong, reiki, therapeutic touch; and bioelectromagnetic therapies: magnetic or light therapy.

TCM and Acupuncture for Cancer Treatment

Chinese medicine has been practiced for 3,000 years or more. Lao Li Xing, director of the School of Chinese Medicine at Hong Kong University, believes that the ancient practice can fill the gaps and overcome some of the limitations of Western medicine, such as cancer and the side effects of treatment. Radiation therapy and chemotherapy are crucial but often have problematic side effects: insomnia, nausea, vomiting, and sometimes dry mouth from the radiation therapy. Chinese medicine can play a bigger role in helping patients’ quality of life. Both Western medicine and Chinese medicine together will get a patient back to good health. [4]

The value of Chinese Medicine lies in its different means of diagnosis and intervention, emphasizing nurturing health, preventing disease, defending capacity in health and disease, and function-oriented wellbeing of a person as a whole. Often Chinese medicine offers alternative solutions where conventional medicine fails. Thus, integrating the wisdom and approaches of both TCM and conventional medicine represents a shortcut to meet many unmet medical needs. While a Western doctor investigates what's going on inside his body, a Chinese medicine practitioner conditions the body as a whole, unable to see what's causing a problem specifically -- highlighting the need for a combination and not solely Chinese remedies. [4]

Few studies have examined the complexity of breast cancer survivors’ attitudes, lived experiences, barriers, and perceptions in using TCM as part of their treatment journey. Participants used TCM as a form of self-help and as a complement to standard care. Overall, 100% of the participants used acupuncture, 62% used Chinese herbal medicine, 23% used Qigong, and 23% used Chinese dietary therapy. Participants reported perceived outcomes and health benefits from TCM usage ranging from increased coping mechanisms, relieving stress and side-effects of standard treatment, the desire to be proactive in the treatment journey, and having a locus of control. Some cited the need to have “time-out” and the therapeutic relationship with the practitioner as being important. [5]

Acupuncture for Cancer Treatment in Slovenia

Acupuncture is a well-established and increasingly used complementary method. It is used to relieve pain syndromes resulting from medical treatment (surgery, chemotherapy, radiation). It is effective for chronic neuropathic pain that is resistant to drug treatment, for reducing nausea and vomiting due to chemotherapy and radiation, and for premature menopause in breast cancer and related problems such as hot flushes, which may be accompanied by palpitations, insomnia, mood disorders, and depression. [6]

Acupuncture has been an official method of Western medicine since the late 1960s and early 1970s and, according to the Health Insurance Institute of Slovenia, is available on referral as a method of pain relief. A referral can be issued by a personal physician or an authorized specialist if he or she considers that the patient needs this treatment. Acupuncture treatment for pain under compulsory health insurance is allowed for those conditions resulting from disease or injury of the musculoskeletal or nervous system. [7, 8] [Read more: Acupuncture effective for chronic muscular pain in cancer survivors]

Acupuncture on referral is performed in the pain clinic (so-called Western acupuncture), by anesthetists with additional expertise in this field. There are two types of acupuncture: one is traditional Chinese acupuncture, based on the basics of 2,000 years ago, and the other is Western acupuncture. Unlike TCM, which treats the patient holistically, Western acupuncture combines and uses a selection of points that are suitable for treating specific conditions. [8]

Acupuncture for breast cancer patients is also provided at the Oncology Institute as part of the pain clinic. 120 patients are treated annually, as capacity allows [6]. In the pilot study OREH (O - oncological, REH - rehabilitation), which took place at the Oncology Institute of Ljubljana from 2019 to 2022, 600 breast cancer patients underwent comprehensive oncological rehabilitation. The conclusions of the OREH pilot study show that patients who received integrated rehabilitation had a better quality of life, fewer problems and side effects of treatment, shorter sick leave, and less disability retirement. Patients in the study were referred to: the Department of Psycho-Oncology at the Oncology Institute (OI), treatment at the Clinical Nutrition Unit of the OI, physiotherapy at the OI, treatment for pain and hot flashes at the Pain Clinic of the OI, treatment at the Gynaecology Clinic of the OI, vocational rehabilitation at the URI SOČA, physical rehabilitation at the Institute of Medical Rehabilitation at the UKC Ljubljana, discussion with a family doctor and workshops at the Health Promotion Centres. Due to long wait times for some treatments in Slovenia, such as acupuncture or cognitive behavioral therapy, some patients did not receive treatment immediately or when they needed it most. The average wait time for acupuncture is 120 days. [9]

Cancer is an unpredictable disease that drastically changes one's life and, when combined with treatment, can wreak havoc on our bodies. Unfortunately, there is no miracle cure for cancer. However, a body that is calm, rested and nourished with the necessary nutrients can fight cancer better. That's why complementary therapies, such as TCM and acupuncture, are a great way to help conventional medicine and ensure the best possible chance of recovery. For more information and a personalized treatment plan, consider consulting a TCM practitioner.


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