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NASOPHARYNGEAL CANCER

GENERAL

Clinical Manifestations	Epistaxis, usually a small amount of Blood (initial stage) Nasal obstruction (early stage) Tumor in the nose Tinnitus Deafness Masses of the neck Vernet's syndrome Platoplegia Asymmetry of the palate Disappearance of the mouth opening Migraines Dysphagia Choking sensation while drinking Hoarseness Exophthalmos Blindness Usually asymptomatic at the early stage The tumor may appear as a cauliflower-like nodule or ulceration on the nasopharynx or as membrane erosion of abnormal color If the tumor infiltrates to the submucosal layer, the surface of the membrane will be smooth and the nasopharynx will be depressed Cranial nerve involvement is reflected by: Paralysis of the eyeball Facial hypothesia or hypoalgesia Difficulty opening the mouth Inclination of the tongue when it protrudes Aphasia Paralysis of the soft palate Disappearance of the gullet response
Treatment Principle
Herb Formulas	Nasopharyngeal Cancer #6 Nasopharyngeal Cancer #7 Gan Ju Gua Lou Tang Jia Jian Nasopharyngeal Cancer #10 Nasopharyngeal Cancer #11 Nasopharyngeal Cancer#13 Nasopharyngeal Cancer #14 Nasopharyngeal Cancer #16 Nasopharyngeal Cancer #17 Nasopharyngeal Cancer #18 Nasopharyngeal Cancer #19 Qing Shang Juan Tong Tang Calcine and grind Fr. Lagenariae Ku Hu Lu into a powder with a little Moschus She Xiang and Borneolum Bing Pian. Blow into the nose several times a day. Char Alumen Ming Fan pound into a powder, mix with lard to make a paste and insert into the nostrils with cotton balls. Crush 6g Calcined Alumen Ming Fan and 1.5g Salmiacum Xi Sha into a powder and inhale in small amounts. Pulverize 0.5kg Rx. Semiaquilegiae Tian Kui Zi and immerse in 5kg sorghum or cereal wine for 7 days. Take 50ml three times a day. Take a decoction of 60g Hb. Lobeliae Chinensis Ban Bian Lian and 60 Hb. Erodii/Geranii Lao Guan Cao daily. Decoct 50g Hb. Scutellariae Barbatae Ban Zhi Lian and 50g. Rz. Typhonium Preparatum Zhi Bai Fu Zi. Take daily. Decoct 50g Hb. Scutellariae Barbatae Ban Zhi Lian and 50g Rz. Typhonii Preparata Zhi Bai Fu Zi and take daily. Take 30g Hb. Salviae Chinensis Shi Jian Chuan daily in decoction. Inhale powdered Flos Lonicerae Jin Yin Hua once every two hours. For nasal bleeding: Pound into small pieces Hb. Hydrocotyli Sibthorpioiditis Tian Hu Sui and insert into the nose. With severe Headache: Nasopharyngeal Cancer #8 Late-Stage with headache, tinnitus and deafness: Nasopharyngeal Cancer #9 For lymphatic metastasis:Nasopharyngeal Cancer #12 For side effects of radiotherapy (sore throat, dry mouth and anorexia): Yang Yin Qing Fei Tang modified Zhi Ai San For acute decrease in leukocytes after radiotherapy: Ba Zhen Tang modified For post-radiotherapy: Hematite and Aster Combination modified For bleeding: Inhale the ashes of Fol. Artemisiae Argyi Ai Ye drink the uncharred herb in decoction. Topical: Cancer #8
Points

SHANG HAN-TAI YANG LEVEL WIND-COLD TURNS TO HEAT

Clinical Manifestations	Epistaxis, usually a small amount of Blood (initial stage) Nasal obstruction (early stage) Tumor in the nose Tinnitus Deafness Masses of the neck Vernet's syndrome Platoplegia Asymmetry of the palate Disappearance of the mouth opening Migraines Dysphagia Choking sensation while drinking Hoarseness Exophthalmos Blindness Usually asymptomatic at the early stage The tumor may appear as a cauliflower-like nodule or ulceration on the nasopharynx or as membrane erosion of abnormal color If the tumor infiltrates to the submucosal layer, the surface of the membrane will be smooth and the nasopharynx will be depressed	Cranial nerve involvement is reflected by: Paralysis of the eyeball Facial hypothesia or hypoalgesia Difficulty opening the mouth Inclination of the tongue when it protrudes Aphasia Paralysis of the soft palate Disappearance of the gullet response Fever and chills Maybe fever only Achiness Anhidrosis Headache Cough Asthma Aversion to Cold Edema Thirst Restlessness Irritability Fidgeting Constipation Sometimes dry achy eyes T: Normal or red C: Yellow or white P: Floating and tight or rapid
Treatment Principle	Expel Wind Disperse Cold Cool Heat
Herb Formulas	Cang Er Sanmodified Cang Er Sanmodified + Da Qing Long Tang
Points

WEN BING-WIND-HEAT ATTACKS THE LUNG

Clinical Manifestations	Epistaxis, usually a small amount of Blood (initial stage) Nasal obstruction (early stage) Tumor in the nose Tinnitus Deafness Masses of the neck Vernet's syndrome Platoplegia Asymmetry of the palate Disappearance of the mouth opening Migraines Dysphagia Choking sensation while drinking Hoarseness Exophthalmos Blindness Usually asymptomatic at the early stage The tumor may appear as a Cauliflower-like nodule or ulceration on the nasopharynx or as membrane erosion of abnormal color If the tumor infiltrates to the submucosal layer, the surface of the membrane will be smooth and the nasopharynx will be depressed Cranial nerve involvement is reflected by: Paralysis of the eyeball Facial hypothesia or hypoalgesia Difficulty opening the mouth Inclination of the tongue when it protrudes Aphasia Paralysis of the soft palate Disappearance of the gullet response Headache Toothache T: Red tip C: Yellowish P: Wiry and rapid
Treatment Principle	Expel Wind Clear the Heat Dispel the toxins
Herb Formulas	Cang Er Sanmodified
Points

WIND-HEAT ATTACKING THE LUNGS WINT UNDERLYING SPLEEN AND STOMACH HEAT

Clinical Manifestations	Severe sore and swollen throat High fever with convulsions in infants Difficulty swallowing Carbuncles Acute localized infection Lymphangitis Furuncles Abscesses Boils T: Red C: Greasy and yellow P: Rapid
Treatment Principle	Expel Wind Clear Heat Ventilate the Lungs
Herb Formulas	Liu Shen Wan
Points	DU-14, DU-16, GB-20, LI-4 + LU-7 or LI-4 + SJ-5, LU-5, LU-10, LU-11, ST-44, UB-12, UB-13

DAMP-HEAT OF THE LUNGS AND STOMACH

Clinical Manifestations	Epistaxis, usually a small amount of Blood (initial stage) Nasal obstruction (early stage) Profuse nasal discharge Tumor in the nose Tinnitus Deafness Masses of the neck Vernet's syndrome Platoplegia Asymmetry of the palate Disappearance of the mouth opening Migraines Dysphagia Choking sensation while drinking Hoarseness Exophthalmos Blindness Usually asymptomatic at the early stage The tumor may appear as a Cauliflower-like nodule or ulceration on the nasopharynx or as membrane erosion of abnormal color If the tumor infiltrates to the submucosal layer, the surface of the membrane will be smooth and the nasopharynx will be depressed Cranial nerve involvement is reflected by: Paralysis of the eyeball Facial hypothesia or hypoalgesia Difficulty opening the mouth Inclination of the tongue when it protrudes Aphasia Paralysis of the soft palate Disappearance of the gullet response Nausea Vomiting Poor appetite T: Normal C: Stick and white P:Deep and thready
Treatment Principle	Clear the Lungs Transform Phlegm Eliminate Dampness Dissolve toxins
Herb Formulas	Er Chen Tang modified
Points

LUNG AND KIDNEY YIN DEFICIENCIES

Clinical Manifestations	Emaciation A dark, dull complexion Weariness Shortness of breath Distress Insomnia Dry mouth and throat P: Thin and rapid
Treatment Principle	Nourish Lung and Kidney Yin Clear Heat Detoxify
Herb Formulas	Yang Yin Qing Fei Tang Nasopharyngeal Cancer #15
Points

LIVER BLOOD STAGNATION WITH PHLEGM

Clinical Manifestations	Tumors usually found on the side of the neck The lump enlarges and hardens gradually with no pain Headache on the corresponding side as the tumor Tinnitus Mucous discharge with Blood Depression Anorexia T: Stains from Stagnant Blood C: Slightly thick and white P: Tight
Treatment Principle	Dissipate Stagnant Blood Dissolve the Phlegm Detoxify
Herb Formulas	Chai Hu Bie Jia Qian modified
Points

DAMP-HEAT IN THE LIVER AND GALL BALDDER

Clinical Manifestations	Yang jaundice (sclera and skin bright yellow) Pain and fullness in ribs on both sides Maybe pain in the right hypochondrium Bitter taste in mouth Nausea Vomiting sour and bitter fluids Anorexia Maybe alternating chills and fever Concentrated, dark urine Abdominal distention Women: Yellow vaginal discharge with foul smell Pruritis vulvae Men: Pain, swelling and burning sensations of testicles T: Pink C: Yellow and greasy or sticky P: Wiry and rapid or Slippery and rapid
Treatment Principle	Clear Dampness Purge Heat from Liver and Gall Bladder
Herb Formulas	Nasopharyngeal Cancer #23
Points	Dannangxue, DU-9, GB-24, GB-34, LIV-14, SI-4, SP-9, UB-18, UB-19, UB-48

HEAT IN THE GALL BLADDER CHANNEL

Clinical Manifestations	Epistaxis, usually a small amount of Blood (initial stage) Nasal obstruction (early stage) Tumor in the nose Masses of the neck Migraines Vernet's syndrome Disappearance of the mouth opening Choking sensation while drinking Hoarseness Blindness Usually asymptomatic at the early stage The tumor may appear as a Cauliflower-like nodule or ulceration on the nasopharynx or as membrane erosion of abnormal color If the tumor infiltrates to the submucosal layer, the surface of the membrane will be smooth and the nasopharynx will be depressed Cranial nerve involvement is reflected by: Paralysis of the eyeball Facial hypothesia or hypoalgesia Difficulty opening the mouth Inclination of the tongue when it protrudes Aphasia	Paralysis of the soft palate Disappearance of the gullet response Exophthalmos Dysphagia Platoplegia Asymmetry of the palate Severe, splitting headaches with dizziness Sudden tinnitus or deafness Flushed face Red, swollen, painful eyes Irascibility with violent angry outbursts Dry mouth Bitter taste in mouth Thirst Vomiting sour or bitter liquid Insomnia Restlessness Constipation or dry stools Maybe rib pain In severe cases (due to Liver Fire damaging the Luo Mai): Mania Bleeding of Excess Heat type: · Hemoptysis · Hematemesis · Epistaxis T: Red tip and edges C: Thick, yellow, dry and rough P: Wiry, Excess and rapid
Treatment Principle	Invigorate the Brain Qi Clear away pathogenic Heat from the Gallbladder Relieve Stagnation of Gallbladder Qi Clear Lung Heat
Herb Formulas	Nasopharyngeal Cancer #1 Fang Feng Tong Sheng San Cang Er Zi San Xiao Feng San modified Ju Fang Zhi Bao San
Points

YIN DEFICIENCY

Clinical Manifestations	Epistaxis, usually a small amount of Blood (initial stage) Nasal obstruction (early stage) Tumor in the nose Tinnitus Deafness Masses of the neck Vernet's syndrome Platoplegia Asymmetry of the palate Disappearance of the mouth opening Migraines Dysphagia Choking sensation while drinking Hoarseness Exophthalmos Usually asymptomatic at the early stage The tumor may appear as a Cauliflower-like nodule or ulceration on the nasopharynx or as membrane erosion of abnormal color	If the tumor infiltrates to the submucosal layer, the surface of the membrane will be smooth and the nasopharynx will be depressed Cranial nerve involvement is reflected by: Paralysis of the eyeball Facial hypothesia or hypoalgesia Difficulty opening the mouth Inclination of the tongue when it protrudes Aphasia Paralysis of the soft palate Disappearance of the gullet response Blindness Thirst Dryness of the tongue Dry feces T: Red C: Peeled or Thin and yellowish P: Thready and rapid
Treatment Principle	Nourish Yin Clear Heat Dissolve toxins
Herb Formulas	Nasopharyngeal Cancer #2 Qi Ju Di Huang Wan With Qi Deficiency and Internal Heat: Nasopharyngeal Cancer #24
Points

PHLEGM-HEAT

Clinical Manifestations	Cough with sticky, yellow, difficult to expectorate sputum Rapid breathing with a harsh voice Restless fever Sore throat Constipation Dry stools Mania Shortness of breath Dyspnea Nausea Chest and/or epigastric fullness Pain in the ribs T: Scarlet C: Yellow or Yellow and greasy or Yellow and smooth P: Rapid and smooth or Slippery and rapid
Treatment Principle	Clear Heat Resolve Phlegm
Herb Formulas	Nasopharyngeal Cancer #21
Points	LI-11, LU-5, ST-40, UB-13

TOXIC HEAT STAGNATION

Clinical Manifestations	Purulent nasal discharge Epistaxis, usually a small amount of Blood (initial stage) Nasal obstruction (early stage) Tumor in the nose Tinnitus Deafness Masses of the neck Vernet's syndrome Platoplegia Asymmetry of the palate Disappearance of the mouth opening Migraines Dysphagia Choking sensation while drinking Hoarseness Exophthalmos Blindness Usually asymptomatic at the early stage The tumor may appear as a cauliflower-like nodule or ulceration on the nasopharynx or as membrane erosion of abnormal color	If the tumor infiltrates to the submucosal layer, the surface of the membrane will be smooth and the nasopharynx will be depressed Cranial nerve involvement is reflected by: Paralysis of the eyeball Facial hypothesia or hypoalgesia Difficulty opening the mouth Inclination of the tongue when it protrudes Aphasia Paralysis of the soft palate Disappearance of the gullet response Headache Aching of the body Preference for cold drinks T: Slightly purple with or without echymotic patches C: Yellowish P: Wiry and thready or Slippery and thready
Treatment Principle	Clear the Heat Dispel the toxins Activate the Blood Dissolve Stasis
Herb Formulas	Nasopharyngeal Cancer #3 Liu Shen Wan Cancer #6 With Wind-Dampness: Nasopharyngeal Cancer #20 Nasopharyngeal Cancer #22 Nasopharyngeal Cancer #25
Points

UPPER NOSE

Clinical Manifestations	Pronounced cancerous swelling Headache Tinnitus Dry throat Stuffy nose Numbness of the face Double vision Deviation of the mouth and eyes T: Red or Pink C: Thin and yellowish P: Wiry and slippery
Treatment Principle	Drain Liver Heat Pacify Liver Yang Attack and relieve Fire toxins Dissipate nodules Reduce abscesses Treat tumors
Herb Formulas	Nasopharyngeal Cancer #4
Points

LOWER NOSE

Clinical Manifestations	Metatastic tumors of the cervical lymph nodes with pronounced cancerous swelling Emotional depression Irascibility A bitter taste in the mouth Dry throat Movable hard tumor in the neck T: Red tip C: Thin and white P: Wiry and thready
Treatment Principle	Dredge Liver Qi Release Stagnation Stop pain Relieve toxicity Dissipate nodules Clear Heat Dissolve Phlegm Reduce swelling
Herb Formulas	Nasopharyngeal Cancer #5
Points