Paraneoplastic syndromes and palliation by homoeopathy

Dr Neil Praisy 

ABSTRACT:
Paraneoplastic syndromes are rare disorders that are triggered by an altered immune system response to a neoplasm. They are defined as clinical syndromes involving nonmetastatic systemic effects that accompany malignant disease. In a broad sense, these syndromes are collections of symptoms that result from substances produced by the tumour, and they occur remotely from the tumour itself. 

The treatment of malignant disorders is incomplete if we are not taking into consideration the manifestation of paraneoplastic syndrome.  We may be able to achieve the best palliation, when we are able to incorporate the above symptoms into the totality. This is an effort to focus on the different types of paraneoplastic syndromes and the indicated homoeopathic medicines.

KEY WORDS: Paraneoplastic syndromes, cancer, homoeopathy, similimum, palliation.

INTRODUCTION:
In incurable cases, we must not ruminate that we are having limitations in the probability of the similimum. If the symptomatology of the disease and pathology is obliterated with the selected similumum, it ameliorates the suffering of the patient.

Paraneoplastic syndromes are a set of signs and symptoms consequently from substances [such as hormones or cytokines] produced by the tumour, and they ensue at a distant site from a tumour or its metastasis. Sometimes, the symptoms of paraneoplastic syndrome are perceived, when the tumour- immune response breaks immune tolerance and commences to attack the normal tissue expressing it.

 The most common causes accompanying with paraneoplastic syndromes include:

  • Lung carcinoma(common)
  • Hepatocellular carcinoma
  • Renal carcinoma
  • Leukaemia
  • Lymphomas
  • Breast tumours
  • Ovarian tumours
  • Gastric cancers
  • Pancreatic cancers
  • Neural cancers

GENERAL NEOPLASTIC SYMPTOMS:
ANOREXIA AND CACHEXIA seen due to reduced food consumption or local obstruction by tumours in the alimentary canal. Control of appetite can be altered by tumour factors such as serotonin. FEVER may be due to drugs, infection or any reaction to blood products.

Hyrdrastis canadensis- Has action on all the mucous membranes.it stimulates the digestive process and increases assimilation of food.

Cachexia cancer, stomach cancer, breast cancer, malnutrition

Arsenicum album-It is a very deep acting remedy which affects every tissue and organ. Loss of weight due to impaired nutrition.

Anorexia, cachexia, cancer

Carcinosin (cancer nosode)-Acts on all cases with a family history of cancer or previous history of cancer and even if symptoms are still existing

Cancerous affections, breast cancer, cancerous cachexia, emaciation

CUTANEOUS PARANEOPLASTIC SYNDROMES:
PRURITIS-most common in leukaemia, lymphomas and CNS tumours due to hyper eosinophilia. PIGMENTED SKIN LESIONS- Acanthosis nigricans (GI cancer), Bowens disease (lung, GI, GU cancer). PARANEOPLASTIC PEMPHIGUS – erosions of oral mucosa, lips and conjunctiva (lymphoma, Kaposi sarcoma) and generalised dermic melanosis.

Radium bromatum-Effective in skin affections and ulcers due to radiation burns

Erythema, dermatitis, itching

Muriaticum acidum-It acts on the mucous membrane of the mouth.

Aphthae, mouth ulcers, dry cracked lips

X-ray-repeated exposure to x-rays produce skin lesions followed by cancer

Radiation dermatitis

HEMATOLOGICAL PARANEOPLASTIC SYNDROMES:
ANAEMIA- seen in bone marrow involvement with cancer, blood loss after chemotherapy and radiotherapy, nutrition deficit where the erythropoietin levels are low. DISSEMINATED INTRAVASCULAR COAGULATION-the mechanism involved is chronic thrombotic phenomena seen in AML, adenocarcinomas. THROMBO PHELEBITIS-due to hypercoagubility in pancreatic, GI and lung cancers.

Vanadium metallicum-It acts as an oxygen carrier and a catalyser, increases haemoglobin

Anaemia, cachexia, emaciation

Trinitrotoluenum- It marked action in anaemic condition due to destruction of red blood corpuscles

Anaemia, haemorrhages, cyanosis

X-ray –Has a property of stimulating cellular metabolism. Arouses vitality mentally and physically

Anaemia, chronic fatigue, leukaemia, haemophilia, haemorrhage

GASTRO INTESTINAL PARANEOPLASTIC SYNDROME:
WATERY DIARRHOEA with subsequent dehydration and electrolyte imbalance may be an outcome from tumour related secretion of prostaglandins or vaso active intestinal peptides. MALABSORPTION- in lymphoma of small bowel due to hypalbuminaemia.

Phosphorous- Has powerful action on gastro intestinal tract.

Diarrhoea, glossitis, petechial spots

Arsenicum album- A complementary to Phosphorous, its main centre of action is gastro intestinal mucosal membrane

Cancer, Dropsy, diarrhoea, gastritis, gastroenteritis, pains

RENAL PARANEOPLASTIC SYNDROMES:
MEMBRANOUS GLOMERULONEPHRITIS -in colon, ovarian cancers and lymphoma because of circulating immune complexes. NEPHROTIC SYNDROME -in advanced cancers due to renal vein thrombosis and systemic amyloidosis.

Teribinthiniae oleum-Important sphere of action lies in the region of kidneys, in the urinary mucous membrane

Albuminuria, dropsy, kidney disorders, nephritis

Apocynum cannabinum- Action on the mucous membrane along with the vascular system of the kidneys. It produces copious diuresis

Anasarca, renal dropsy, scanty urine

RHEUMATOLOGIC PARANEOPLASTIC SYNDROMES:
ARTHROPATHIES-predominately seen in haematologic cancers or cancers of colon, pancreas or prostate. HYPERTROPHIC OSTEO ARTHROPATHY- manifests with swelling of joints with effusion and fingertips in lung cancers. DERMATOMYOSITIS – A pathological muscle inflammation and necrosis is noticeable which progress to proximal muscle weakness. A dusky, erythematous butterfly rash on cheeks with periorbital oedema may advance.

Kali hydriodicum – A strongly marked action upon fibrous tissue and joints. Its produces thickening of the periosteum

Arthritis, cancer, joint disorders, lumbago, rheumatism

Asafoetida-A syphilitic remedy indicated in decay of bones with extreme sensitiveness

Bone diseases, darting pain in bones, hypersensitiveness.

ENDOCRINE PARANEOPLASTIC SYNDROMES:
Because of production of peptide hormones by cancers, also stated as ectopic hormones. 

CUSHING SYNDROME- may result from ectopic production of ACTH or ACTH -like molecules, most often with small cell cancer of lung. HYPOGLYCEMIA-Results from production of insulin like growth factors or insulin production by pancreatic islet cell tumours. HYPERCALCEMIA- Increased osteoclastic stimulation resulting in bone resorption most frequently in lung, breast and renal cell cancers, multiple myeloma and T-lymphoma. ECTOPIC ACTH SYNDROME (lung, pancreas and thymus cancers) -where there are elevated levels of ACTH and clinically manifests as polyuria, polydipsia, wasting, fatigue, hypertension, hyperkalaemia. SIADH (small cell lung cancer, GUT, ovary, GI)- due abnormal production of ADH/ADH-like substance by chemotherapy agents.

Iodium: Acts on overall glandular system. The most prominent feature of the action of Iodium is its power of causing absorption

Breast affections of, cancer, cachexia, profound debility, great emaciation, metabolic disorders, weight loss

Adrenalinum: Employed when there is increased glandular activity. It stimulates the activity of sympathetic nerve endings. Has a vasoconstriction action -most powerful and prompt astringent and haemostatic 

Cancer patients with adrenal disturbances, debility, glycosuria, palpitations, rapid pulse, rapid emaciation, wasting 

NEUROLOGIC PARANEOPLASTIC SYNDROME:
PERIPHERAL NEUROPATHY-a distal sensorimotor polyneuropathy that causes mild motor weakness, sensory loss and absent distal reflexes. SUB-ACUTE SENSORY NEUROPATHY-  there is a degeneration of dorsal root ganglia and progressive sensory loss with ataxia, but little motor weakness develops. EATON -LAMBERT SYNDROME -is an immune mediated syndrome with weakness affecting limbs ad pelvic girdle sparing ocular and bulbar muscles. Diagnosed by Electro myelogram. OPSOCLONUS-Involuntary chaotic eye movements associated with cerebellar ataxia and myoclonus of trunk and extremities. ENCEPHALITIS-global encephalitis seen in small cell lung cancer. Limbic encephalitis-anxiety, depression leading to memory loss, behavioural abnormalities, hallucinations and confusion. SUB -ACUTE CEREBELLAR DEGENERATION – Especially in women with breast and ovarian cancer. causes bilateral leg and arm ataxia, dysarthria and sometimes vertigo and diplopia. Along with these signs observed here are dementia, ophthalmoplegia, nystagmus.

Zincum metallicum- Has powerful tonic action upon the peripheral extremities of the motor and sentient nerves

Cerebral exhaustion, meningitis, neuralgia, neurasthenia, paralysis

Lachesis mutus – Has a special centre of action on cerebro-spinal system especially nerve centres

Cancer, chorea, epilepsy, locomotor ataxia, neuralgia, paralysis

Gelsimium sempervirens- A grand centre of action is upon the motor portion of the spinal cord

Convulsions, brain disorders, Diplopia, locomotor ataxia, tremors

OTHER REMEDIES:

Malandrinum- efficacious in clearing the remnants of cancer deposits

Echinacea angustifolia-A blood and immune tonic, especially in the last stage of cancer

Calendula officinalis- in cancer it acts an intercurrent remedy

CONCLUSION:
Homoeopathic remedies stimulate the immune system ,to confront the underlying manifestations of cancer when selected ,based on fundamental principles of homoeopathy. We as physicians must take into consideration the pathophysiological action of our remedies along with the complete symptoms of the disease which will pave to the similimum and eventually will palliate the sufferings promptly. 

BIBLIOGRAPHY:

  1. Roberts AH. Principles and Art Cure Homoeopathy. reprint edition. New Delhi: Indian Books and Periodicals Publishers; 2012.162-168.
  2. Burt WH. Physiological Materia Medica. New Delhi: B. Jain Publishers(P)Ltd;1995.
  3. Murphy R. Lotus Materia Medica.3rd edition. New Delhi: B. Jain Publishers(P)Ltd ;2010.
  4. Boericke W. Pocket Manual of Homoeopathic Materia Medica and Repertory. New Delhi: B. Jain Publishers(P)Ltd;2002.
  5. Fauci AS, Kasper DL, Dongo DL, Braunwald E, Hauser SL, Jameson JL, Loscalzo J. Harrison’s principles of internal medicine .17th edition. Volume 1. New York:MC Graw Hill Companies, Inc;2008.617-623.

Dr Neil Praisy
PGT Department Of Practice Of Medicine
Fr Muller Homoeopathy Medical College. Mangalore
Guide : Dr MK Kamath

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