Yi-Po Anthony Wu, MD, M.P.H.
Medical Director and founder of PCMC

• Western medical training at National Taiwan University, Worcester City Hospital, University of Massachusetts Medical Center
• Masters degree in Public Health, University of Hawaii
• Diplomate, American Board of Internal Medicine
• Acupuncture training in Taiwan and at New York University
• Director of Pacific Pain Clinic 1988-93
• Director of Pacific Complementary Medicine Center since 1999
  

PCMC has continued to thrive and succeed in carrying out its mission to bring the best of eastern & western medicine to the people of Stockton. During the last few months, several good results came out of researches conducted in the western world regarding Traditional Chinese Medicine (TCM).

One example is the NIH funded research at Yale University School of Medicine on acupuncture treatment for cocaine. The medical profession has finally recognized drug dependency as a chronic illness and recommended treatment.

Another example is PC-SPES, an herb formula for the treatment of prostate cancer. The clinical results are promising though the herbs in PC-SPES are not regulated pharmaceuticals. Winter is just around the corner with shorter days and colder weather.

More people will experience or develop fatigue and depression. Chronic pain may worsen during this period. It is important for us to recognize the signs of winter blues and deal with them properly. The reason why during winter we are down more physically and emotionally is, according to Chinese medical theory, the lack of qi.

This calls for tonic herbs to strengthen the person. In the winter, a good use of tonic herb is essential to promote our well being and to reduce chronic pain. Please read the article on SAD (Seasonal Affective Disorder).

 In Peace & Health,

          Yi-Po Anthony Wu, MD

Year 2000 is the Year of the Dragon. Good fortune comes with the dragon. PCMC is indeed having a prosperous and prolific year. Dr. Brian Loh had a grandson in March, Michael Shi’s baby girl arrived on May 14, Albert and Liz Cordero’s baby boy (see picture insert) was born on August 18, and Linda McKinney is expecting. Congratulation to all!

TOPIC OF THE DAY -
Seasonal Affective Disorder (Winter Blues)

Every year around this time, many people have symptoms of fatigue and depression. Some mention that they are too tired to go to work and some say they are moody with family members. Many complain of trouble with their diet.

Seasonal Affective Disorder (SAD) is not uncommon to my practice anymore. Actually, one study has shown 10 million Americans were affected with full-blown SAD. In the southern part of our country about 1% of the population was affected and in the northern part it could reach 10%. The best way to treat SAD is to prevent it by early detection.

In a mild case, a proper re-arrangement of diet and activity will help you through the winter. For self-management of SAD, we need to pay attention to our diet. It should be high in vegetables and low in animal products. The root of the plant is preferred because it nourishes the yin energy and calms our mood.

Try to avoid sweets because they affect the blood sugar level unstable and hence our mood. It is important to avoid weight gain. In winter, we should extend our sleeping hours to at least eight a day or one to two hours more than our average. Health exercises such as tai chi, qi-gong, and yoga, should be done one hour before sunrise or after sunset.

Relaxing movements are preferred for people who have more of a problem with depression. When more help is needed, some herbs such as St. John's Wort or Kava Kava are beneficial. Chinese herbs such as Xiao Yao Wan and Ba Zhen Wan and some tonic herbs such as Dang qui and Ginseng are also beneficial.

Melatonin can be helpful for insomnia. Because there is a variety of herbs and dosages, it would be advisable to see an herbalist or a physician. Acupuncture treatment is also helpful. An acupuncturist can distinguish the different conditions of the SAD. Some people with PMS or a weight disorder may come down with severe SAD.

The treatment should be more aggressive by the professionals. In some severe cases, prescription medicine such as anti-depressants or tranquilizers may be considered, but this should be used only for a short period of time. In summary, SAD is a common and serious illness that should be managed properly. Most people can handle this through lifestyle changes, herbs, and acupuncture. But some should visit their physician for further medical treatment.

At Pacific Complementary Medicine Center, herbs, acupuncture, exercise, and medical treatment are all available. The wellness program is from 5:00 to 6:00 p.m. daily, Monday through Friday, for relaxation and combating SAD.

In the fall or winter do you:

· Get depressed and irritable?

· Have trouble waking up in the morning?

· Crave sugar and other carbohydrates?

· Feel sluggish and low-energy?

· Have trouble focusing on work and relationships?

· Feel like the world is a dark and difficult place and that life is just not any fun?

· Experience relief from these symptoms once the days lengthen and spring arrives?

If you answered "yes" to most of these questions, you may be suffering from SAD.

HERBAL THERAPY PC-SPES:
IN VITRO EFFECTS AND EVALUATION OF ITS EFFICACY IN 69 PATIENTS WITH PROSTATE CANCER

PC-SPES IN PROSTATE CANCER
Editorial Comment
Ian M. Thompsom, Jr.

Complementary and alternative medicine is used by more than 40% of patients in the United States, and urology patients are no exception. Patients seek complementary and alternative medicine for a variety of reasons, including failure of traditional therapy, avoidance of side effects, desire for a more natural approach to healing and desire to maintain control over therapy.

Thus, it is not surprising that men with prostate cancer have sought out such an approach because hormonal therapy fails with time, has multiple meaning and protean side effects, is prescribed and administered by physicians, and often leads to polypharmacy.

Into this environment moves PC-SPES, a combination of 1 American and 7 Chinese herbs. This study and others demonstrate unequivocally that this amalgam has activity in prostate cancer, and clinically causes a decrease in PSA. In the mixed population of men with prostate cancer responses in PSA were the rule with about three-quarters exhibiting a PSA decrease of greater than 50%, which is a threshold often used to declare The results of this study, especially the clinical results, should prompt more interest in PC-SPES.

However, I am disturbed by several observations. The mechanism of action of the agent remains unknown, and the specific component(s) of the agent that cause this effect remain(s) unknown.... The sterols in this agent, although dissimilar to estrone, estradiol and diethylstilbestrol are nevertheless estrogens and can be expected to cause other cardiovascular side effects.

Without large scale detailed clinical trials we will not know if the degree of cardiovascular mortality is less than or greater than that previously seen with diethylstilbestrol.The findings of this report are exciting and disturbing. We have evidence that some or all of the compounds in this admixture have an effect on hormone refractory prostate cancer that may be highly significant.

The prospect of lives saved in an otherwise incurable disease is an electrifying development. It comes at a risk, however, of a serious side effect. If this agent had undergone appropriate testing by a pharmaceutical manufacturer we would know an appropriate dose, have a tailored combination of agents, and have detailed information regarding side effects and methods to possibly prevent them.

Because of the lack of regulation of agents such as these, physicians and patients must take the place the of agency that provides oversight for regulated pharmaceuticals.

Journal of American Urological Association 20

Drug Dependence, a Chronic Medical Illness
McLellan, Lewis, O’Brien, and Kleber

The effects of drug dependence on social systems has helped shape the generally held view that drug dependence is primarily a social problem, not a health problem. In turn, medical approaches to prevention and treatment are lacking.

We examined evidence that drug (including alcohol) dependence is a chronic medical illness. A literature review compared the diagnoses, heritability, etiology (genetic and environmental factors), pathophysiology, and response to treatments (adherence and relapse) of drug dependence vs type 2 diabetes mellitus, hypertension, and asthma.

Genetic heritability, personal choice, and environmental factors are comparably involved in the etiology and course of all of these disorders. Drug dependence produces significant and lasting changes in brain chemistry and function.

Effective medications are available for treatment nicotine, alcohol, and opiate dependence but not stimulant or marijuana dependence. Medication adherence and relapse rates are similar across these illnesses.

Drug dependence generally has been treated as if it were an acute illness. Review results suggest that long term care strategies of medication management and continued monitoring produce lasting benefits. Drug dependence should be insured, treatment and evaluated like other chronic illness.

JAMA October 4, 2000 - Vol 284, No. 13

A RANDOMIZED CONTROLLED TRIAL OF AURICULAR ACUPUNCTURE FOR COCAINE DEPENDENCE

Background: Partly because of a lack of a conventional, effective treatment for cocaine addiction, auricular acupuncture is used to treat this disorder in numerous drug treatment facilities across the country for both primary cocaine-dependent and opiate-dependent populations.

Objective: To evaluate the effectiveness of auricular acupuncture for the treatment of cocaine addiction.

Methods: Eighty-two cocaine-dependent, methadone-maintained patients were randomly assigned to 1 of 3 conditions: auricular acupuncture, a needle-insertion control condition, or a no-needle relaxation control. Treatment sessions were provided 5 times weekly for 8 weeks. The primary outcome was cocaine use assessed by 3-times-weekly urine toxicology screens.

Results: Longitudinal analysis of the urine data for the intent-to-treat sample showed that patients assigned to acupuncture were significantly more likely to provide cocaine-negative urine samples relative to both the relaxation control (odds ratio, 3.41; 95% confidence interval, 1.33-8.72; p=.01) and the needle-insertion control (odds ratio, 2.40;95% confidence interval, 1.00-5.75; p=.05)

Conclusions: Findings from the current study suggest that acupuncture shows promise for the treatment of cocaine dependence. Further investigation of this treatment modality appears to be warranted.

Arch Intern Med. 2000; 160:2305-2312

HIERBAS BUENAS - Tonic Herbs

In TCM tonic herbs constitute an important and the most frequently used herb category. Since the Chinese consider the imbalance and deficiency of qi to be the main reason of illness, tonification, i.e., to correct with tonic herbs is a very common method of treatment.

According to its function, qi can be further categorized into (1) Weiqi which deals with immunity and the nerve system; (2) Yingqi or the essential qi which deals with nutrition, blood, and digestion; (3) Yang and (4) Yin which deal with the reproductive functions in male and female. Essential qi is the one inherited from our parents and is the foundation of all other qi.

Healthy people should retain adequate and balanced qi so they can function well in every aspect of their life, emotionally and physically. Because of internal (genetic/inherited) and external (environmental and nutritional) health factors, some people may develop a deficiency of qi which will present with many symptoms such as fatigue, insomnia, anxiety, irritation, depression, and menstrual problem and irregular bowel habit.

Pain threshold will be lowered, resulting in persistent and chronic pain condition. Western-trained physicians will usually treat people suffering from chronic depression, fatigue and pain with anti-depressants or tranquilizers.

These mood-altering medications may be effective in the short term when a person is taking it, but it carries some potential side effects and may lead to dependency. In most non-acute, non-critical situations, for most people, it is advisable to consider other safer and natural options such as counseling, acupuncture, herbs, exercise, and basic lifestyle changes.

Tonic herbs are commonly used to deal with health problem arising from qi deficiencies. Corresponding to the four categories of qi, tonic herbs are classified into four groups: (1) buqi, tonics for Weiqi; (2) buxue, tonics for Yingqi; (3) buyang, tonics for Yang; and (4) buyin, tonics for Yin.

PCMC Herb Center carries all these herbs. The use of all herbs need to be regulated by a qualified herbalist. In Traditional Chinese Medicine, tonic herbs have been used not only as medicine but also as food for general health and prevention. Tonic herbs can be consumed in tea, wine, soup, or prepared with other recipes. Especially in wintertime, TCM emphasizes the use of tonic herbs to preserve energy and to promote immunity.