Cholangiocarcinoma (CC), also known as gall bladder cancer, is a malignancy of the biliary duct system and may originate either in the liver or the extrahepatic bile ducts. More than 95% of these tumors are ductal adenocarcinomas and many patients present with inoperable or metastatic disease. Long-standing inflammation and chronic parasitic infection are believed to be responsible for this condition. Common symptoms include jaundice, clay colored stools, dark urine, itching, weight loss and abdominal pain.
The Ayurvedic treatment of CC is aimed at treating the tumor, controlling the symptoms, preventing a blockage of bile flow, infection and other complications and prolonging life. Ayurvedic medicines like Arogya-Vardhini, Triphala-Guggulu, Kanchnaar-Guggulu, Punarnavadi-Guggulu, Chandraprabha-Vati and Bhunimbadi-Qadha are used to treat the actual tumor. Herbal medicines like Kutki (Picrorrhiza kurroa), Sharpunkha (Tephrosia purpurea), Kalmegh (Andrographis paniculata), Punarnava (Boerhaavia diffusa), Karela (Momordica charantia), Trikatu (Three pungent herbs), Pippali (Piper longum), Marich (Piper nigrum), Mandukparni (Centella asiatica), Haridra (Curcuma longa) and Daruharidra (Berberis aristata) can also be used for this purpose. Most of these herbal medicines also reduce inflammation and prevent infection.
Medicines like Yashtimadhuk (Glycyrrhiza glabra) and Amalaki (Emblica officinalis) can prevent or treat complications like fistula formation. These medicines need to be given in very high doses round the clock, in order to heal fistulas resulting from the tumor. In order to prevent a recurrence of fistula, these medicines should be continued for at least two months after complete healing has occurred. Some patients are not in a position to swallow medicines, for example, those with severe vomiting. For such patients, the medicines can be powdered, mixed with milk and honey, and then administered by a syringe, through a nasogastric tube.
Medicines like Kutki, Trikatu, Shankh-Vati, Chitrakadi-Vati, Hingashtak-Churna and Samudradi-Lavan-Churna can be used to treat jaundice and abdominal pain. Itching is usually caused because of a deposition of bile pigment under the skin. This symptom can be treated using medicines like Haridra, Amalaki, Trikatu and Triphala (Three fruits). Weight loss is usually treated by the basic treatment of the tumor itself. However, extensive weight loss can be treated using medicines like Suvarna-Malini-Vasant, Suvarna-Sutshekhar-Ras, Suvarna-Parpati, Panchamrut-Parpati, Ashwagandha (Withania somnifera), Shatavari (Asparagus racemosus), Bala (Sida cordifolia) and Naagbala (Grewia hirsuta).
Medicines like Mahamanjishthadi-Qadha, Saarivasav, Kanchnaar-Guggulu and Punarnavadi-Qadha can be used to prevent the spread of the tumor to other parts of the body. These medicines, in combination with immunomodulatory medicines, have a combined effect in prolonging life for the affected patients. Immune-boosting medicines include Tulsi (Ocimum sanctum), Bhrungraj (Eclipta alba), Triphala, Abhrak-Bhasma, Suvarna-Bhasma and Heerak-Bhasma.
CC is generally considered to have a poor prognosis with an overall survival of approximately six months, despite aggressive modern anti-cancer therapy and interventional supportive care. Ayurvedic treatment, therefore, has a definite role to play in treating this tumor and prolonging life.