Ayurvedic Treatment for Basal cell carcinoma
Introduction
Basal cell carcinoma or in short, BCC is a nonmelanocytic skin cancer. It comes under the group of epithelial tumours that arise from basal cells. They are small, round cells seen in the lower layer of the epidermis. The prognosis for patients with BCC is excellent when diagnosed in early stages, but if the disease is in later stages, mortality rate is high. Approximately 85% of BCCs develop on the face, head including scalp included, and neck. But it can also develop on the trunk or extremities. Ver rarely though, they develop on the hands.
BCC tumours have the following characteristics:
- Waxy papules of central depression
- Pearly appearance
- Erosion or ulceration mostly central with pigmentation
- Bleeding when cut
- Big tumours may have oozing and crust formations on them
- Black, bluish or brown areas are seen with raised border
- Translucent tumour
- Telangiectasis on the surface
- Slow growth
Tumours of BCC are classified on the clinicopathological basis.
- Nodular – They are the most common cystic, pigmented, keratotic form of BCC. They are manifested as round, pearllike, flesh-coloured papules with telangiectasis.
- Infiltrative – when the tumor infiltrates the dermis in the thin strands between the collagen fibers. In such cases, margins of tumour will be less clear.
- Micronodular – They are not ulcerated mostly. They are seen as yellow-white when stretched. They are firm when touched, with a well-defined border
- Morpheaform – They are white or yellow, waxy, sclerotic plaques that rarely ulcerate. Flat with slight depression, they are fibrotic and firm,
- Superficial – Mostly seen on the trunk or shoulders, they appear like an erythematous, patch or plaque often with a whitish scale with well-marked margins.
Causes of basal cell carcinoma
The exact cause of BCC is not known, but environmental and genetic factors are considered taking a role in the predisposition of BCC.
Pilosebaceous cysts or units are found related with the development of BCC. They are tumours mostly seen on areas with hair.
Some scholars say that BCCs develop as a result of pluripotential cells in the basal layer of the epidermis or follicular structures. These cells are continuously formed entire life time. They shape hair, sebaceous glands, and apocrine glands. Tumours develop from the epidermis in most cases but rarely arise from hair follicle root cells.
Treatment of carcinoma
Surgery
In most cases of BCC, Surgery is recommended. The following surgical procedures are done:
- Electrodesiccation and curettage
- Excisional surgery
- Mohs micrographically controlled surgery
- Cryosurgery
Other therapies include:
Radiation therapy – In people those who can not tolerate surgery, Radiation therapy is advised. BCC is radiosensitive in most cases. It is also done in patients after surgery for a complete elimination of the tumour.
Photodynamic therapy – It is done as an extra or supporting therapy in conditions like:
- Recurrent tumour with atrophied tissue and scar formation
- Old and weak patients or patients with comorbidities
- Tumours without clear margins or borders
- Tumours in which difficult or extensive oculoplastic surgery is needed
Pharmacologic therapy include:
Topical
5-fluorouracil 5%
Imiquimod
Tazarotene
Oral
Hedgehog pathway inhibitors
Vismodegib
Sonidegib
Cemiplimab
Complications of medicine & treatment
Though having excellent outcome, chance of recurrence in the first year is very high. It may be found in other sites too. Regular check-ups and close watch are advised.
Preventive measures
Avoid factors like exposure to sun, ionizing radiation, arsenic ingestion, and tanning beds. The regular use of sun protection clothes and sunglasses with ultraviolet protection) while going out in the sun.
Ayurvedic Concept of Basal cell carcinoma
Cancer is a terrifying name in the modern society but it is explained in Ayurveda books written thousands of years ago. Though the term cancer or carcinoma was not coined, clinical presentations similar to the conditions are explained in detail. Carcinoma can be understood mostly under two terms Granthi & Arbuda which denote the non-inflammatory & inflammatory stages of carcinoma respectively in most cases. In some cases, vidradhi can also be correlated as carcinoma. Regarding basal cell carcinoma, it can be understood well in terms of Ayurveda as Granthi.
In Ayurveda, tumours are considered as granthi which are unwanted and abnormal growths which can develop wherever possible in the body. Ayurveda explains that the vitiated doshas travel from their sites throughout the body and get lodged where there are abnormality or damage in the circulatory channels (srotas). When the doshas cause granthi in the skin, it ccan be correlated with Basal cell carcinoma. In later stages, Arbuda or vidradhi can be the condition.
Ayurvedic Nidana of Basal cell carcinoma
Causative factors for the vitiation of tridoshas
Unwholesome diet and lifestyle
Ayurvedic treatment for Brucellosis
The aim of Ayurvedic treatment in granthi is to remove and expel the kapha dosha blocking the normal functioning of Vaata. This will help the skin cells formation and its functioning in the normal way. To eliminate kapha, vamanam and nasyam are done if the patient is suitable. After clearing the obstruction in channels, treatment is given to enhance the skin formation and development in a normal way. Both internal medicines and external treatments are needed for a long time. In the first stage, the body should be cleared from Aama (metabolic toxic waste products accumulated in the body). This is done by diet restrictions, fasting, and medicines. Sedentary lifestyle & depressive mood should be changed into an active & enthusiastic one. Medicines are given to enhance the digestive fire or Agni. Internal medicines and diet with ushna-teekshna (hot, pungent & penetrating) properties are advised if there is no paaka or pus formation. For complete cure of the existing disease and prevention of recurrence, cleansing therapies called Ayurveda Panchakarma should be administered under expert supervision. The most suitable therapy and herbal medicines are decided after individual examination. Generally, it includes oil massage & intake of medicated ghee or oil as part of Snehana therapy. Then the body is allowed to sweat in Swedana therapy. After this, therapeutic emesis or Vamana should be done in young & strong patients. For complete cleaning of the gastro-intestinal tract, therapeutic purgation or Virechana with herbal medicines or formulations should also be done. By this, aggravated Pitta dosha is pacified. In conditions where Vaata dosha is aggravated, therapeutic enema or Vastis should be done. This can be done either with herbal oils or decoction mixtures. Herbal powder massages or herbal paste applications (Udwartana & lepana) on the skin are also prescribed. In suitable patients, oil massage & herbal decoction baths are advised.
Commonly used internal medicines are:
Pachanamrutam kashayam
Amruthotharam kashayam
Punarnavadi kashayam
Gugguluthikthakam kashayam
Aragwadhadi kashayam
Aragwadharishtam
Pippallyasavam
Kisoraguggulu
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Writer:
Consultant,
Ayurveda Medicine, India
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.
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