AYUHOM

REVIEW ARTICLE
Year
: 2021  |  Volume : 8  |  Issue : 2  |  Page : 42--50

Blue print of Ayurvedic modalities to prevent risk factors in cancer


Amulya Murthy Aku, Ashok Patil 
 KAHER'S Shri BMK Ayurveda Mahavidyalaya, Post Graduation Studies and Research Centre, Belagavi, Karnataka, India

Correspondence Address:
Amulya Murthy Aku
KAHER'S Shri B.M.K Ayurveda Mahavidyalaya, Post Graduation Studies and Research Centre Shahapur, Belagavi - 590 003, Karnataka
India

Abstract

The cancerous process is the result of disturbed cell function. This is due to the accumulation of many genetic and epigenetic changes within the cell, expressed in the accumulation of chromosomal or molecular aberrations, which leads to genetic instability. Cancer is an uncontrolled growth disorder of cells characterized by the formation of tumor, invasiveness, metastasis, and anaplasia. Ayurveda describes a variety of clinical conditions which have approximate similarities with cancer. The disease is a major cause of motility and morbidity across the world. Despite a huge advancement in therapeutic strategies, it is still a major cause of death worldwide. Prevention of cancer is the need of the hour. To explore and understand the modifiable, nonmodifiable risk factors of cancer as well as to find out the various Ayurvedic preventive perspective, this review study has been undertaken. Ayurvedic classics, articles, books, and journals were gone through manually for relevant theories and principles related to risk factors of cancer and how they contribute to cancer. Ayurvedic modalities were also explored, which can help to prevent these risk factors. On exploring different literatures, it was found that mainly under modifiable risk factors-diet, lack of activity, stress, habits (e.g., smoking and alcohol), environmental factors, and unsafe sex with infected personals (human papillomavirus) contribute to cancer. While under nonmodifiable risk factors, family history was found to be a main contributory risk factor.



How to cite this article:
Aku AM, Patil A. Blue print of Ayurvedic modalities to prevent risk factors in cancer.AYUHOM 2021;8:42-50


How to cite this URL:
Aku AM, Patil A. Blue print of Ayurvedic modalities to prevent risk factors in cancer. AYUHOM [serial online] 2021 [cited 2023 Feb 2 ];8:42-50
Available from: http://www.ayuhom.com/text.asp?2021/8/2/42/348863


Full Text



 Introduction



Cancer is one of the most dreadful diseases. The repercussion of modernization and present lifestyle and dietary habits is highly influenced by Western culture.[1]

Cancer is the second-leading cause of death globally, accounting for an estimated 9.6 million deaths, or one in six deaths, in 2018. Lung, prostate, colorectal, stomach, and liver cancer are the most common types of cancer in men, whereas breast, colorectal, lung, cervical, and thyroid cancer are the most common among women. The projected incidence of patients with cancer in India among males was 679,421 (94.1/100,000) and among females 712,758 (103.6/100,000) for the year 2020. One in 68 males (lung cancer), 1 in 29 females (breast cancer), and predicted that 1 in 9 Indians would develop cancer during their lifetime (0–74 years of age).[2]

The global cancer burden is increasing, putting enormous physical, emotional, and financial strain on individuals, families, communities, and health-care systems. Many low- and middle-income countries' health systems are unprepared to handle this burden, and many cancer patients worldwide lack timely diagnosis and treatment. The availability of early detection, appropriate treatment, and survivorship care is boosting cancer survival rates in countries with strong health systems. Between 30% and 50% of malignancies can be prevented by avoiding risk factors and using proven preventative methods. Many tumors can be cured if detected early and treated properly. Cancer has a poor prognosis in later stages. Chemotherapy and radiotherapy have high side effects with no promise of improved patient quantity or quality of life.[3] Patients in that circumstance, especially in India, are victims of lack of information, neglect, and emphasis on therapy rather than prevention. Most of the causes contributing to cancer are easily prevented with minor adjustments in lifestyle, nutrition, and other factors.

The need of the hour is prevention, but the focus is being implied on treatment. No doubt treatment is also required and essential to treat cancer, but there is no effective cure yet found which can increase the lifespan, let alone improve the quality of life. Therefore, until there is an effective discovery cure for cancer, it is better to prevent this disease as much as possible. Ayurveda is the science of life, in which the science of healthy and prolonged living is described very beautifully. The main objective of this science is “swasthasya swastha rakshanam,” which means the focus is laid on preventing the disease even before it is developed by promoting and maintaining health. Ayurveda describes many regimens and rules, regulations, treatment modalities that have proven to help do so for thousands of years. This article mainly focuses on various risk factors as acharyas have primarily focused on “nidana” (risk factors); studying and exploring these will give us an idea of how to prevent them. The article also focuses on various preventive modalities described in Ayurveda that can prevent the disease.

 Ayurvedic Concept of Cancer



Ayurveda, an Indian system of treatment that has been around for over 5000 years and is still effective, may not be acquainted with the word “cancer.” However, with names such as Apachi (can be compared to lymphadentitis), Gulma (tumors), Granthi (minor neoplasm), and Arbuda (major neoplasm), Ayurvedic classics are fully aware of clinical characteristics comparable to cancer. Ayurvedic classics describe cancer as inflammatory and noninflammatory swelling and refer to it as Granthi and Arbuda, respectively.[4]

The etiological factors exacerbate Vata, Pitta, Kapha, and some of the Dushyas, such as Rakta, Mamsa, and Meda, causing tumors and neoplasms (Arbuda) and impact all regions of the body. According to Acharya Sushrutha, there is a pathogenic damage to sixth layer of skin is called “Rohini” along with muscle tissues and blood vessels.[4]

 Objective



To explore and understand the modifiable, nonmodifiable risk factors of cancer as well as the various Ayurvedic modalities with the purpose to find the preventive aspect of these modalities.

 Methods



Ayurvedic classics, articles, books, and journals were gone through manually for relevant theories and principles related to risk factors of cancer and how they contribute to cancer. Ayurvedic modalities were also explored, which can possibly help to prevent these risk factors.

 Results



After going through the literature, it was found that there are many risk factors that cause cancer that makes it multifactorial disorder. These risk factors play a great role in Ayurveda and it is the primary step to ward off the diseases even before they have occurred.[5] Risk factors can be modifiable,[6] or nonmodifiable.[7]

Modifiable risk factors of cancer: Diet, physical activity, smoking, alcohol, environment, stress, disturbed sleep, recurrent infections,Nonmodifiable risk factors of cancer: Family history, genetics, blood group.

According to Ayurveda, these factors can be broadly described under Trayopsthambas or three sub pillars of life: Ahara (food and nutrition), Nidra (sleep), and Brahmacharya (celibacy and lifestyle)[8] [Table 1].{Table 1}

 Physical



Ahara (diet)

Unhealthy diets that lack nonstarchy vegetables, fruits, dietary fiber, and essential nutrients are dietary factors identified by the World Cancer Research Fund (WCFR) as being associated with cancer.[9],[10]

A correlation was found between overweight, body mass index, and increased risk of cancer.[11],[12] Obesity has been linked to large intestine, breast, rectal, pancreatic, gallbladder, ovarian, and prostate cancers, according to the World Cancer Research Fund (WCRF). Obesity is estimated to be a factor in at least 20% of the 1.5 million new cancer cases each year.

Consumption of red and processed meats raises the risk of developing colon cancer. Vitamin A and iron deficiency are further risk factors for mouth cancer. Colorectal cancer and other dietary-dependent malignancies are increasingly being studied for their insulin- and insulin-like growth factor-dependent carcinogenic effects. It has been discovered that a high glycemic index is associated with an increased risk of cancer.[13],[14] Saturated fat, excessive salt, smoked or pickled foods, as well as foods that are too oily and spicy are all considered carcinogenic.[15] Other factors such as mutagenic and carcinogenic substances are listed out in [Table 2].[16]{Table 2}

Lack of physical activity

Over 500 epidemiologic studies have studied the link between physical exercise and cancer incidence. The World Cancer Research Fund (WCRF)/American Institute for Cancer Research recently examined and summarized this research as part of their guidelines on physical activity for cancer risk reduction. Strong evidence suggests that physical activity appears to lessen the incidence of bladder, breast, colon, endometrial, esophageal, and stomach cancers. Moderate evidence suggests that higher levels of physical exercise may reduce the risk of kidney, ovarian, pancreatic, and lung cancer.[17]

Sedentary lifestyle and cancer

Sedentary behaviors include all waking activities with an energy expenditure ≤1.5 metabolic equivalents of task (METs) performed in the sitting, reclining, or lying postures (e.g., watching television, working at a computer, sitting in a vehicle). The 2018 PAGA Committee concluded that high levels of sedentary time are related to an elevated risk of colon, endometrial, and lung cancers, with insufficient evidence of a dose-response relationship.[18]

 Habits



Smoking

Tobacco usage is a major cause of cancer and mortality. Tobacco products and secondhand smoke include several chemicals that harm DNA, increasing the risk of cancer. N-nitrosonornicotine, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone, and polycyclic aromatic hydrocarbons are all carcinogenic in tobacco (PAHs). Tobacco use causes many types of cancer, including cancer of the lung, larynx (voice box), mouth, esophagus, throat, bladder, kidney, liver, stomach, pancreas, colon and rectum, and cervix as well as acute myeloid leukemia. People who use smokeless tobacco (snuff or chewing tobacco) have increased risks of cancers of the mouth, esophagus, and pancreas.[19]

Alcohol

Alcohol consumption increases the risk of cancer of the mouth, throat, larynx, esophagus, liver, and breast. The International Agency for Research on Cancer has identified alcohol as a Class I carcinogen for liver cancer. Alcohol enhances neoplasia by acting “directly on the mucous membrane.” Alcohol consumption increases the already high risk of mouth and throat, larynx, and esophageal cancer in people who smoke. According to some researchers, drinking wine is the most important of all risk factors.[20]

 Mental



Sleep

Sleep and the immune system have a reciprocal relationship and control. Sleep disruptions and sleep deprivation can cause the immune function to be suppressed, as well as a shift in the balance of cytokine production from type-1 anticancer cytokines like interleukin-2 (IL-2) and interferon-gamma to types-2 cancer-stimulatory cytokines. This could be due to a decrease in lymphocytes like natural killer cells and cytotoxic tumor-infiltrating lymphocytes. Inflammation of IL-10, a type-2 anti-inflammatory cytokine that promotes cancer growth through its immune suppressive function, is common. It is undervalued and jeopardized, but is necessary for physical and mental health.[21]

A study examined shift workers, lack of sleep, and daytime napping link with breast cancer risk. Those with shorter (6.0 h/day) and longer sleep duration raised breast cancer synergistically as compared to women with 6.1–8.9 h/day sleep.[22] Recent epidemiological studies have indicated that women working night shifts had an increased risk of breast,[23],[24],[25],[26] endometrial,[27] and colorectal cancer,[28] whereas men working night shifts had increased prostate cancer risk.[29]

Stress

Chronic stress has been linked to numerous diseases, including cancer, in modern lifestyle societies. Chronic stress causes cancer cells and the tumor microenvironment to activate specific signaling pathways, resulting in tumor growth and development.

According to a meta-analysis, workplace stress is a significant risk factor for lung cancer, colorectal cancer, esophageal cancer, and total cancer. Work-related stress and the risk of lung, colorectal, and esophageal cancers may explain some of the differences in cancer incidence between men and women, as well as between geographical areas.[30]

Infections

The WHO recommends that carcinogenic infections such as Helicobacter pylori, human papillomavirus (HPV), hepatitis B virus, hepatitis C virus, and Epstein–Barr virus were responsible for almost 13% of malignancies diagnosed globally in 2018. Infections with Helicobacter pylori are linked to stomach cancer, HBV and HCV are linked with liver cancer. The Epstein–Barr virus (EBV), which causes nasopharyngeal carcinoma and Burkitt's lymphoma, has been discovered in tumor cells. HPV, Chlamydia trachomatis, Trichomonas and vaginalis, are the major risk factor for cervical cancer.[31]

 Environmental



Circadian rhythm

The circadian clock imposes rhythms in key components of the immune system and maintains homeostasis in inflammatory processes. Disruption of circadian rhythms affects multiple immune system functions and leads to chronic inflammation. These alterations foster tumor initiation, progression, and metastasis. Intriguingly, the crosstalk occurring between the circadian clock and the immune system can be exploited for the generation of innovative immunotherapy approaches.[32]

Pollution

Prolonged exposure to particulate matter (PM) present in air pollution is one of the main risk factors for not only lung cancer but also other cancers. A systematic review has summarized cohort studies that aimed to find the association between ambient PM and cancer risk. Current studies provide evidence of an adverse effect of outdoor PM exposure on lung cancer.[33],[34]

A review and meta-analysis found an increased risk of urinary bladder cancer in motor vehicle drivers, who were occupationally exposed to a considerable amount of traffic-related air pollution (Manju et al., 2009). Recent animal studies have shown that exposure to PM2.5 can induce angiotensin/bradykinin system imbalance, subsequent early kidney damage and oxidative stress, and/or inflammation, which finally can cause cancer (Aztatzi-Aguilar et al., 2016).

 Nonmodifiable Risk Factors



Genetic factors

Family history

Some cancer-causing genes are inherited. They form when a fertilized egg or sperm cell's genes defect. Every cell in the body inherits the faults of the sperm or egg cell. Germline mutations are faulty genes that can be inherited down generations.

A child has a 50% chance of inheriting a genetic defect from a parent. Carcinoma is not always caused by defects, but they are more prone to some cancers. They also get cancer younger. The strength of these associations varies by study, cancer location, sex, and age strata, with younger probands having the strongest.[35]

 Discussion



Ayurveda has the better modalities for the prevention of diseases like cancer. Trayopsthambha – the subpillars described in Ayurveda – can be used so that the modifiable and nonmodifiable risk factors can be prevented.

Ahara

Ayurveda considers Ahara (food) as one of the three supporting pillars. It is given names such as “Brahma” in Upanishad and “Mahabhaisajya” in Kashyapa Samhita, to point its importance.[36] In Ayurveda, certain set of dietary guidelines, rules and regulations are described, for example, Ushnamashniyat: food when consumed fresh will have lowest risk of production of nitrates, etc., which are produced due to processing and storage. Certain guidelines about safe processing of food are also described by Charak [Table 3].{Table 3}

NIDRA

In Ayurveda, special importance is given to “Nidra” or sleep. Acharya Charaka, explain, whether you are happy, unhappy, obese, undernourished, strong, weak, manly, sterile, educated or uneducated, long lived or short lived depends on how well you are sleeping. While a good night's sleep brings joy and long life, lack of sleep will have the exact opposite impact.[40] [Table 4] describes advices that are recommended for the management of sleep:{Table 4}

 Brahmacharya



Brahmacharya

CelibacyLifestyle: Dinacharya, Ritu-shodhana, Vyayama, Rasayana, Sadvritta, Achara Rasayana, Ashtanga Yoga.

Celibacy

Ayurveda describes Brahmacharya as one of the three subpillars of existence, the other two being Ahara and Nidra. Brahmacharya is a Sanskrit term meaning abstinence from sex and sex-associated actions from the body and mind. Abstinence not only covers the physical aspect but also the mental aspect of health. Brahmacharya is an effective approach for preventing STDs and promoting healthy sexual life.[41]

Lifestyle

Dincharya is the Sanskrit term made up of two words, “Dina,” which means daily/day; “charya” means routine/practices that combine for “all the practices that one must follow in the daily routine”. In Ayurveda, dincharya is given importance as it is synchronized with the circadian rhythm of nature with the biological clock of the human being. Therefore, ensure to establish the balance in Tridoshas and hence assist in prevent diseases and maintain positive health[42],[43],[44]Some of the modalities like nasya can prevent lung cancer and brain tumor while Dhumpana, kavala, gandusha can prevent oral cancer.

Ritu Shodana

Many studies have been conducted proving the direct link of environmental changes and cancer. Environmental factors such as UV rays, ionizing radiations, X-rays, air pollution, water pollution, hormonal therapy, even viruses and bacteria are the risk factors for cancer. In such cases, regular shodhans should be carries out so that toxins are removed constantly from the body and prevent the occurrence of disease[45]In Ayurveda, the cancer is also correlated with the concept of Dushivisha and Shodhana is considered as best to remove vishaRegular shodhana therapy can reduce the risk of cancer occurring due to family history.

Rasayana (Rejuvenation)

Rasayana treatment is one of the specialized branches in Ayurveda. Several experimental studies have proved that Rasayana compounds have several antitumorogenic properties[37]Many studies and case reports prove the efficacy of Rasayana therapy in tumor regression as well as the efficacy of Rasayana as an adjuvant therapy in chemotherapy, and radiotherapy. Due to its immunomodulatory effect, it can surely be used regularly to prevent cancer as well[38],[39]Regular use of Rasayana along with Shodhana (bio-purification) can also reduce the risk of cancer in individuals with family history of cancer.

 Mental Health Management



Stress is one of the major risk factors and the following are the modalities that can help to overcome stress

Achara Rasayana

Achar Rasayana mainly focuses of psychological aspects, it helps in maintaining the equilibrium of Manas Doshas by increasing the satva guna. Any disturbance in them will give rise to Manas Vikaras like Kama, Krodha, etc., and thus diminishing the Ojas and immunity. Thus, the person is free from emotional disturbances and gives less stressful life and maintains adequacy of the defensive system. Stress is mainly prevented and stress is said to increase free oxygen radical due to high respiratory oxygen intake and metabolic turnover. It mainly has preventive significance since it prevents the person from doing Pragynaparadha and thus preventing unnecessary consumption of etiological factors, which disturbs the health.[46]

Sadvrutta (good conduct)

Sadvritta is a word coined in Ayurveda classics which denotes a code of conduct to keep equilibrium condition of body and mind. Sadvritta not only includes mental perceptions but also includes rules related to general hygiene, sexual intercourse, food consumption following which leads to the promotion of psychological health and prevention of psychological and psychosomatic diseases; moreover, some of sadvritta are play an important role in preventing communicable diseases and sexually transmitted diseases as well. Following Sadvrutta will not only help in preventing cancers caused due to psychological distress but also will help to prevent cancers due to STDs.[47]

Yoga

Yoga may not cure cancer but can help the healing by building physical, mental, and emotional endurance. Yoga works a long away for the prevention of cancer. The eight limbs of yoga can work in every dimension of health to build immunity, calm down the stress, increase physical strength, and overall well-being. Yogic Prayer, Shodhana Kriyas (yogic cleansing techniques) like Jalaneti (nasal cleansing yogic practice), Kapalbhati, Yogic Sukshma Vyayama, and Yogasanas can help to prevent cancer [[Table 5]. Gives a protocol of yoga for cancer prevention].[48],[49]{Table 5}

 Conclusion



The results and discussion suggest that it is critical to study and comprehend the idea of “nidaana,” or risk factors, especially in the case of cancer, which has a poor prognosis. The existing therapy approaches are ineffective in curing the condition and have several side effects with no assurance of lifespan quantity or quality. In this instance, finding measures to prevent the disease becomes critical. Most cancer risk factors can be avoided with easy procedures and alternatives. Ayurveda has proven to be a better option when it comes to prevention. It is past time for additional cancer prevention studies to be conducted.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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