1

Angiogenesis and Breast Cancer causes, diagnosis, metastasis and treatment with
Traditional Avicennian Medicine (TAM)

Laleh Bakhtiar, Ph. D. and Peyman Adeli Sardo

Objective: Angiogenesis and Breast cancer causes, diagnosis, metastasis and treatment with
Traditional Avicennian Medicines (TAM)

Methods: We reviewed the original five volumes of the Canon Of Medicine from Avicenna
1
and
also books from Rhazes
2
and other sources for TAM breast cancer treatment as well as research
on angiogenesis, which is essentially a revival of humoural theory.

Results: After researching angiogenesis and TAM, we found that TAM has effective techniques
for preventing angiogenesis in breast cancer because of its basis in humoural theory. More
clinical trials are needed to study TAMs anti-angiogenic measures which will further
angiogenesis research. Research could confirm the preventive effects TAM can have on
angiogenesis development of breast cancer by understanding the humoural make-up of blood.
First, in TAM the main focus on anti-angiogenesis is on fixing the diet with cold tempered foods
as an angiogenic supplied cancerous tumor is hot and bloody. Second, is relieving stress. These
are the two main causes of tumor angiogenesis according to TAM. Therefore, in TAM the
emphasis is on prevention through a diet of cold tempered foods and the treatment of breast
cancer through anti-angiogenic cold, natural medications. In addition, treating the causes as well
as the symptoms and the tumor itself are the best options in preventing the primary tumor
angiogenesis from metastasizing. We know that most deaths from breast cancer are from the
metastasis of the primary breast cancer, something first noted by TAM over 1000 years ago.

Conclusions: It is interesting that with TAM and its humoural theory, a diet of too many hot
tempered foods and stress are the main causes of tumor angiogenesis whether in the breast or
elsewhere in the body. TAM refers to the importance of diet and eliminating stress for the
treatment of angiogenesis in breast cancer as well as other types of cancer. Breast cancer is the
number one form of cancer in women worldwide. It is very important to be able to prevent it as
well as to develop methods for an early diagnosis in addition to treating it. Having a good and
healthy stress free (emotional and physical) life and a good diet of cold tempered foods is the best
prevention for any type of cancerous angiogenesis, including breast cancer. Preventing cancer
angiogenesis in the first place before a microscopic tumor grows is the best way forward.

Keywords: breast cancer, Avicenna, traditional Avicnnian medicine, humour, angiogenesis, anti-
angiogenic, anti-angiogenesis

Traditional Avicennian Medicine (TAM)

Introduction
Physicians in ancient Persia play an important role in the development of medicine in the
medieval era. One of the most influential figured in this era is Abu Ali Sina or Ibn Sina (980-
1037 BC), known as Avicenna in the western world. Avicenna published 200 books on medicine
and philosophy. His masterpiece in medicine is the al-Qanun fil-tibb or The Canon of Medicine,
which he completed in 1025 CE. This work presents a clearly organized summary of all medical
knowledge of that time. Avicenna follows and expands on the tradition of western philosophy and
medicine introduced by Hippocrates, Aristotle and Galen, among others. He creates a system of
medicine that is known today as holistic medicine. His Canon contains some of most illuminating
2
ideas pertaining to the distinction between mediastinitis and pleurisy, the contagious nature of
phthisis, and disease transmission through water and soil, in addition to careful description of skin
problems, sexual diseases and nervous aliments.
3

The principle of TAM is based on four substances contained in blood at the time of the
formation of the blood clot. This blood clot contains the humours. Each humour in the blood has
two specific qualities: Sanguine humour or blood is hot and moist; bilious humour or yellow bile
is hot and dry; atrabilious humour or black bile is cold and dry; and phlegmatic humour or
phlegm is cold and moist. It is the humours that maintain balance in the body. When the humours
are balanced, the body is healthy and when not, there is imbalance or disease including cancer.
4

Angiogenesis is a process that takes place in both health and disease based on blood. It is
blood that carries oxygen and the organs required nutrients to all parts of the body through the
blood vessels such as the arteries and returns the toxins and wastes from the organs to be purified
through the veins. Whenever a new tissue is formed, it is vital (called vital energy in TAM) that
the new tissue have a supply of blood in order to grow and sustain itself. This is what makes the
formation of blood vessels or angiogenesis essential. As angiogenesis is the formation of new
blood vessels, tumors that are microscopically present in the body, require angiogenesis to grow.
According to TAM, tumors begin to grow when the humours in the body are out of balance,
mainly as a result of a bad diet or too much stress. This is where angiogenic inhibitors come into
play in order to prevent the formation of new blood vessels that feed the tumor. This, then,
prevents the tumor from growing or, at least, slows down the growth of cancerous tumors.

Diagnosis
As we said, according to Avicenna, a tumor angiogenesis occurs from the burning of
black bile (atrabilious humour) because of the imbalance it has created. He indicates that the
increase of innate heat (angiogenesis) becomes pathological. The cancerous tumor now being fed
through angiogenesis can usually be differentiated from benign tumors by the signs of pain,
acuteness, and some degree of throbbing and rapid increase in size.
5
A swelling or tumor is a manifestation of this black bile substance boiling in the blood
through angiogenesis at its junction with the organ. Angiogenic cancerous tumors also send out
crab-like tracks. These tend toward blackness, greenness and heat. Avicenna mentioned that
angiogenesis cancer also occurs in hollow organs and passageways. It is common in the nerves,
muscles, tendons and lymph nodes as well as the breast.
6
It is worth noting that both Rhazes and Avicenna identified several types of cancerous
angiogenic areas including:
7
The eye, nose, tongue, stomach (gastric), liver, urinary tract, kidney,
testis and breast cancer, as well as spleen and nerve tumors.
8

One study has stated
9
that Avicenna was not referring to breast cancer when speaking
about cancer because the breast is not a hollow organ and also because breast cancer is not
usually associated with pain, but I believe this person has not studied Avicennas Canon Of
Medicine, Volume 3. I have just completed the first English translation of this work and can
clearly state that Avicenna has a section on solid swellings or tumors of the breast and that he
mentioned the treatment for it.
The diagnosis of cancer with TAM is based on a physical exam and the signs and
symptoms in the patient who has cancer including a study of the humours in the blood.

Prevention of Metastasis
Avicenna also says, a physician has excised a cancerous breast radically. Then
cancer developed in the other breast. My opinion is that the second breast might have been on its
way to cancerization (a dormant cancer) that fits this case. It is possible that the cancerous
material from the first breast spread to the other and this is clear
10
It is very interesting to note
that Avicenna explained the metastasis process of cancer over 1000 years ago.
3
Avicenna says: As to preventing the progress and metastasis of cancer, it can be
achieved by improving the diet and reinforcing the involved organ by the known effective
natural medications that treat the blood humours through its opposite
11
He also mentioned to prevent metastasis, Cancer can be reached by controlling the
bloods atrabilious humour, improving the diet and reinforcing the involved organ by the known
effective natural medicines, and by using mineral ointments like those containing millstone dust
and whet-stone dust. These ointments are pounded in a mortar and pestle. The pestle has
previously been moisturized with aromatics such as rose oil and coriander water. The natural
medications then mix with the aromatics when the substance is pounded in a mortar. Avicenna
added, Also, a dressing with well pounded verjuice is good and useful.
12


Treatment
Avicenna says, We have to understand that the best and most effective remedy for the
treatment of breast cancer patients where angiogenesis has increased to feed the tumor, should be
through the improvement of the power of the human body by increasing its immune system
which is based on their environment and having the patients listen to the best music and allow
their best friends to be with them.
13
In Avicennas view, the first objective in the treatment of cancer is to keep it as stationary
as possible so that it will not increase and to keep it non-ulcerated. A cure, he notes, is most likely
if treatment is begun at the earliest stage.
14

Avicenna described four ways to treat cancer: 1. total arrest (but it is difficult); 2.
preventing metastasis; 3. preventing ulceration; 4. treating the ulceration. And those natural
medications the aim of which is to arrest the cancer are those the aim of which is to reverse what
happened through excess production of atrabilious humour in the blood and preventing its
affecting the organ involved.
15

Avicenna mentioned that medications should not be of much strength, . . . since strong
natural medication increases the production of blood vessels (angiogenesis) in patients diagnosed
with cancer.
16
In addition, he says, One should avoid irritant natural medications and for this,
good natural medications are pure minerals like washed pure tutty mixed with oils like rose oil
and the oil of yellow gillyflower.
17

Medications used in the prevention of ulceration were described as ointments that
prevent the progress of cancer provided they would not irritate. All of them are useful, especially
if mixed with the mixture mentioned above of aromatics on the pestle and then pounding it in a
mortar with other natural medications. If added to sealing clay or Armenian bole oil or houseleek
water, ceruse and lettuce juice, or the mucilage of fleawort or ceruse of lead constitute a good
preparation. Of great benefit is a dressing with raw or soft river crab.
18

Both Rhazes and Avicenna realized that a cure is most likely if the cancer is diagnosed at
its earliest stage. Avicenna says, When the cancer is advanced and well-established, it cannot be
cured.
19

Avicenna also mentioned the earliest medicinal treatment for cancer. One method he
discovered was the use of Hindiba (chicorium intybus), a herbal compound drug which Ibn al-
Baytar
20
later identified as having anti-angiogenic properties and which could also treat other
tumors and neoplastic disorders.

Surgery: Even with careful surgery and strict dietary therapy, Avicenna adds this strong
caution: Nevertheless, most of the time, excision increases the cancer.
21
Further surgery is
often needed and in this there may be a great danger if the cancer was in the vicinity of the
principle organs and the precious vital organs.
22
Apparently Avicenna performed surgery on the aunt of the Shah of Persia at that time to
remove a breast tumor. He used a combination of opium and cannabis for it.
23
He suggests
surgical removal of the tumor if it is small and accessible and not close to the major organs
(brain, heart, and liver). Avicenna says, The excision should be radical and all diseased tissue
4
should be removed which includes the use of amputation or the removal of veins running in the
direction of the tumor so that nothing of these will be left.
24
He also mentioned the use of
cauterization for the area being treated if necessary.
25

As we mentioned the cause of cancer according to TAM is burning of black bile
(atrabilious humour) in the blood through the process of angiogenesis that provides nutrients to an
organ. Therefore, the first and initial step in the treatment of an angiogenic-fed cancerous tumor
should be inducing vomiting and diarrhea by using methods and medications for removing black
bile from the body in addition to removing veins running in the direction of the tumor to prevent
metastasis. Also due to the heat or hotness of the angiogenic-fed cancerous tumor, cold tempered
plant-based natural medications should be used for treatment to neutralize and starve the heat of
angiogenesis. Rhazes and all previous physicians recommend treating with cold tempered plant
medications in the third and fourth degrees like prickly lettuce, lettuce, Syrian bryony, flax, black
calla, cabbage, malva and common purslane.
26a

In regard to the degrees of natural medications, Avicenna states in Volume 1 of The
Canon: There are four degrees of medicineswhether eaten, taken in the fluid state, or used as
an ointment: The first degree drugs are those whose action is not ordinarily felt by the body, i.e.,
the heat or cold produced by them is not appreciated unless the drug is taken repeatedly or in a
larger quantity. The second degree drugs are a little more potent, but unless taken repeatedly or in
larger doses, they do not disturb the normal functioning of the body and even when they do so it
is only indirectly. The third degree drugs directly impair the normal functioning of the body but
not to the extent of causing disease or death. The fourth degree drugs are those that cause death or
damage to the body. These are the poisonous medicines that act on account of their quality. The
poisons, of course, kill by their very nature and are thus specific.
27

Avicenna continues, recommending foods that are cold natured such as milk, beans,
barley, common purslane, malva and chicory. They also used mineral-derived materials mainly to
stop and prevent the progression of angiogenesis. Minerals such as zinc, blue vitriol, and iron are
applied on the advanced angiogenic-fed cancerous tumor or immediately after removing of the
tumor through a surgical operation.
28

In the case of hidden cancers becoming manifest after having existed for some time,
Avicenna believes the best thing is to leave the tumor alone. He says, If it is left and not
removed, the patient may remain alive longer, especially if the diet is corrected and made to cool
and to refresh and produce a bland, safer material. Foods should be barley water, mashed fish,
soft-boiled egg yolk, and the like.
29

The initiation and development of new blood vessels or angiogenesis is essential to
supply oxygen and nutrients for a tumors growth and metastasis. Inhibition of blood vessel
formation through anti-angiogenic foods and surgery is suggested by Avicenna. He notes that
cancer can be arrested by vigorous excision including all the blood vessels (angiogenesis)
supplying the tumor so that nothing of these will be left. This is still a promising therapeutic
approach for treating the angiogenic-fed solid cancerous tumor afflicted patients.
30

In The Canon of Medicine, Volume 3, in the part on the breast, Avicenna states, If a
swelling is present in the breast and you see it is becoming hard, you must first soak rice in wine
and prepare a poultice from it. Put it on the swollen breast! Or rub a poultice of beeswax, rose oil,
pitch resin and camphor on the breast. It also might be treated with poultice made of gall nut leaf
or boil wine sediment and rub on the breast. It is also helpful if you boil vinegar sediment and rub
on a painful breast.
If nodules are formed in the breast or there is a rupture in the skin of the breast, the best
medication for it is to grind a green peach leaf and green common rue leaf together and put on the
breast as a poultice.
31

Avicenna also mentions ulceration of the breast and its treatment, prescribing: Acrid
grape wine 20 ratl; raw gall nut ! ratl; and cypress tree fruit 1 ratl. Add all of these medications
to wine. Soak them in wine for 20 days. Then put them in a container and boil. Mix it with
5
cypress tree wood until ! of it is vaporized and ! left. Mix the rest very well and then refine it.
Then boil the refined mixture again to thicken. After this process, put the medication in a glass
and store it. This medication is for an ulcer on the breast and also for any ulcer in the soft organs
such as the mouth and tongue and others. It is the best treatment for them. This medication is also
very helpful in preventing ulcers and curing ulcerated organs.
32

Avicenna is historically known as the first physician who actually tests the natural
medications that he recommends and he observes their benefits. He mentions the natural
medications that he has tested or those that have been tested by physicians who preceded him in
his Canon of Medicine.
The following two tables show medications used to treat cancer. Table 1 shows
Medicinal plants used to treat cancer based on TAM and Table 2 shows The Effects of food and
herbal-derived compounds that can replace chemotherapy:

Table 1
33

Plant Species Preparation Additional uses
Allium cepa L. Bulb juice Diabetes, loos of appetite, liver
disease, coughing, external infection
Anetheum graveolens Seeds Intestine gas, digestive system, eye
inflammations
Artemisia absinthium Seeds Intestinal parasite
Arum palaestinum Leaf Urinary system
Arum palaestinum Boiss. Foliage decoction Internal bacterial infections,
Poisoning, circulatory system
Astoma seselifolium Bulb decoction General tonic, aphrodisiac,
Increasing appetite
Brassica oleracea L. Whole plant juice Respiratory system, asthma, joint
Inflammation, bacterial infection
Caterach officinarum Seeds Constipation, internal bleeding
Crataegus azarolus L. Fruit and flower Cardiovascular diseases, sexual
decoction weakness, diabetes
Crocus sativus Fiber Constipation, liver diseases,
eye inflammations
Cuminum cyminum Seeds Coughing, urinary infections, kidney
stones, liver, digestion problems,
intestinal gas
Cuscuta campesteris Stem Urinary system problems
Eryngium ereticum Leaf, seeds Ulcer, gallbladder and kidney stones
Ficus sycomarus Fiber, stem sap Psoriasis, warts
Glycyrrhiza globra Roots Ulcer, coughing, liver problems,
constipation
Juglans regia Leaf, bark Diabetes, asthma, sexual weakness,
Tooth whitening, fungi
Lens culinaris Seeds Inflammation in mouth, skin
Lilium candidum Flowering parts Headache
Matricaria aurea Flower decoction Stomach, intestine pain, coughing,
Anti-inflammatory
Narcisaus tazetta Bulb, flowers Lung inflammation, coldness
Nigella sativa Seeds Diarrhea, fever, intestinal parasite,
vomiting, general tonic, skin diseases
Papaver Opium Seeds Insomnia, pain, diarrhea
somniferum
Pistacia Lentisaues Seed and leaf Sexual weakness, jaundice,
respiratory problems
Punica granatum Bark Diarrhea, dysentery, ulcer, wounds
6
Quercus calliprions Bark, stem and fruit Fever, ulcer, high blood pressure
Quercus calliprions Decne Fruit and bark Bed wetting, ulcer, diabetes, skin
decoction diseases
Quercus ithaburensis Webb. Stem, bark and fruit Fever, bed wetting, high blood
decoction pressure, ulcer
Sinapis arvensis Seed, leaf General tonic, back pain, rheumatism
Triticum aestivum L. Shoot decoction Anemia, skin disease (seed
decoction)
Urtica pilutifera L. Foliage decoction Stomach, intestine pain and
Inflammation, liver disease, bed
wetting (seeds)
Vicia faba Seeds Skin diseases, whitening
Vinca rosa Leaf Diabetes
Viscum cruciatum Seeds, fruit, foliage Constipation, rheumatism, back ache
decoction
Withania somnifera Seeds Wounds
Zea mays L. Kernel and fiber Urinary system and stones in kidney,
decoction blood pressure, joint inflammation,
and weight loss
34

Table 2
35

Item Active principle Antioxidant Antimetastasis Aproptosis Antianglogenesis
Anti- Effect Induction
Inflammatory
Property
Olives Oleuropein + + + +
Black seeds Thymoquinone + + + +
Onion Quercetin + + +
Garlic Diallyl sulfide + + +
Tumeric Curcumin + + +
Figs Several flavonoids + +
Pomegranate Several polyphenols + + + +
Honey Several active componets + +
Milk thistle Silymarin + + +
Chicory Insulin-type fructans
[beta(2,1)] fructans + + +
Bread wheat Fibers, lignans,
isoflavones and
phoenolic acits +



7
References
1. Abu Ali al-Husayn Ibn Abd Allah ibn Al-Hassan ibn Ali ibn Sina (Avicenna). Persian polymath, physician,
philosopher, astronomer, alchemist, geologist, psychologist, Islamic topologist, and writing on logic, mathematics,
physics, and poetry. August c. 980- June 1037 http://en.wikipedia.org/wiki/Avicenna
2. Razi, Muhammad ibn Zakariya (Rhazes). Persian polymath, physician, alchemist and chemist, philosopher, and
discoverer of alcohol and vitriol (sulfuric acid). 854 CE- 925 CE.
http://en.wikipedia.org/wiki/Muhammad_ibn_Zakariya_al-Razi. R"z#, Ab$ Bakr Mu%ammad ibn Zakar#y". "The
Comprehensive Book on Medicine the Virtuous Life (al-Hawi)". World Digital Library. Retrieved 2014-03-02.
3. Nejabat, M. Maleki, B. Nimrouzi, M. Mahbodi, A. Salehi, A. Avicenna and Cataracts: A New Analysis of
Contributions to Diagnosis and Treatment from the Canon. Iran Red Crescent Med J 2012; 14(5): p 265-266.
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Medicinal Plants and Their Major Chemical Compounds. Journal of Traditional Chinese Medicine, March 2011;
31(1): p 27.
5. Harding, F. Breast Cancer: A Cure At Last. Great Britain: Tekline Publishing: 2006; pp 80-84.
6. ibid.
7. Zaid, H. Saad, B. Cancer treatment in the Arab-Islamic medicine: integration of tradition with modern
experimental trials. Jamaeh number 14 (2010): pp13-20
8. ibid.
9. Harding, F. op. cit.
10. Zaid, H. op. cit.
11. ibid.
12. Watson, R. Preedy, R. Victor. Bioactive Foods and Extracts: Cancer Treatment and Prevention. CRC press:
Taylor and Francis Group: 2011; pp. 50-62.
13. Zaid, H. op. cit.
14. Harding, F. op. cit.
15. Watson, R. op. cit.
16. ibid.
17. ibid.
18. ibid.
19. Zaid, H. op. cit.
20. Ibn al-Baytar al-Malaqi. Muslim scientist, botanist, pharmacist, and physician. 1197-1248
http://en.wikipedia.org/wiki/Ibn_al-Baytar
21. Zaid, H. op. cit.
22. Harding, F. op. cit.
23. Krivitsky, Leonard, MD. My testimony on H.B. 1393 to legalize medicinal Cannabis in PA.
http://www.pahouse.com/Cohen/documents/med_marijuana/Dr%20%20Krivitsky.pdf
24. Zaid, H. op. cit.
25. ibid.
26. Watson, R. op. cit.
27. Avicenna. The Canon of Medicine. Chicago: Kazi Publications, Vol. 1, p. 221.
28. Watson, R. op. cit.
29. Harding, F. op. cit.
30. ibid.
31. Avicenna (Abu Ali al-Husayn ibn Sina). The Canon of Medicine. Chicago: Kazi Publications, Vol 3, NYP.
32. ibid.
33. Watson, R. op. cit.
34. Adapted from Saad, B. et al. (2006). Evid Based Complement Alternate Med 3. 433-439. O. et al. (2002). J
Ethnopharmacol 83, 251-265.
35. Watson, R. op. cit.