In classical Ayurveda tumours and swellings are described under Granthi, Arbuda, Vrana and Vidradhi. Modern malignant neoplasms (cancers) correspond partly to these descriptions — uncontrolled tissue proliferation, invasion and later systemic wasting. Classical texts describe localised nodular swellings (granthi, arbuda), chronic non-healing ulcers and malignant-appearing growths requiring śodhana, śamana and local excision. Modern oncology terms (carcinoma, sarcoma, lymphoma, leukemia) map onto Ayurvedic pathology variably depending on tissue and dosha involvement.

"अर्बुदः कवचवत्स्थः दर्शयते रोगान् ।"
(सुश्रुत संहिता — अर्बुद वर्णनानि, निधान/चिकित्सा परिच्छेद)

Ayurveda explains tumor formation as a sequence of doṣa-dushti (often Kapha-Meda or Rakta-Vata involvement), srotorodha (channel obstruction), prolonged āma (undigested toxins) and subsequent alteration of dhātu (meda, mamsa, rasa, rakta). Granthi/Arbuda originate as localised kaphaja/sannipātaja vriddhi; if neglected, they may ulcerate (Vrana) or form hard obstructive masses. Modern carcinogenesis involves genetic mutations, epigenetic changes, and microenvironmental drivers (chronic inflammation, immune escape, angiogenesis) — factors that classical nidāna partly anticipates (chronic irritation, repeated trauma, rakta vitiation).

Dietary causes (Ahāra Hetu) — classical and modern contributors:

• Ati-snigdha, guru, madhura āhāra — classical foods that promote meda and kapha, predisposing to granthi/arbuda in kaphaja pathogenesis.

  "गुरुस्निग्धाः कफकारकाः ग्रन्थिवर्धकाः स्मृताः"
  (अष्टाङ्गहृदय / सुश्रुत संदर्भः — ग्रन्थि/अर्बुदवर्णन)

• Viruddha-āhāra & Adhyashana — incompatible combinations and overeating producing āma and chronic systemic toxemia.
• Excess processed foods, charred/overcooked meats, preserved/smoked foods — modern dietary carcinogens (heterocyclic amines, polycyclic aromatic hydrocarbons, nitrosamines).
• Tobacco and Betel quid — classical smokeless areca/tuṭha-like substances produce local rakta-kleda vitiation; modern: carcinogens for oral, pharyngeal, lung cancers.
• Alcohol (Ati-madyapāna) — classical nidāna; modern: acetaldehyde-mediated carcinogenesis (oral, esophageal, liver).
• Obesity and high glycemic diet — modern metabolic drivers (insulin/IGF axis) linked to breast, colon, endometrial cancers; classical correlate = Santarpana→ Medovṛddhi.

Lifestyle & environmental causes (Vihāra Hetu):

• Tobacco use (smoking & chewing) — primary modern carcinogen; classical texts warn against harmful habit-forming substances.
• Excess alcohol — classic nidāna and modern promoter of multiple cancers.
• Occupational exposures — asbestos, benzene, aromatic amines, heavy metals, ionizing radiation (modern recognised carcinogens).
• Chronic infections — HPV (cervical, oropharyngeal), HBV/HCV (hepatocellular carcinoma), H. pylori (gastric cancer) — modern etiologies; classical texts note chronic pus/suppuration, krimi involvement in chronic ulcers and gangrenous lesions.
• UV exposure — modern cause for skin cancers; classical caution regarding excessive sun/heat exposure aggravating Pitta and damaging rasa/skin.
• Chronic inflammation and repeated trauma — classical concept of localized doṣa stagnation leading to granthi/arbuda; modern: inflammation-driven carcinogenesis.

Classical Pathogenesis (Samprapti): Chronic nidāna (dietary, lifestyle, trauma, infection) → āma formation & srotorodha (esp. medovaha, mamsavaha, rasavaha, raktavaha srotas) → localized granthi / arbuda (nodular proliferation). If doṣa imbalance persists, granthi becomes hard, ulcerates (vrana), invades adjacent tissues and produces systemic doṣa vikaras and dhatu-kshaya. Vāta involvement in later stages produces pain, cachexia and metastasis-like wasting. Modern pathogenesis parallels: initiation (mutations), promotion (chronic irritation, inflammation), progression (angiogenesis, invasion, metastasis).

"दीर्घसमयेऽमा संचिते स्रोतोरोधे ग्रन्थिः जायते"
(सुश्रुत-वर्णनानुशासन-सार)]

Diagnosis (classical + modern integrated): Clinical inspection and palpation (size, consistency, fixation); classical tests include touch/ sparsha, observation of vrana discharge; modern diagnostic pathway: imaging (USG, CT, MRI, PET-CT), biopsy & histopathology (gold standard), immunohistochemistry, molecular markers, blood tests (tumor markers where applicable), and staging (TNM).

• Localized, persistent lump or nodule
• Induration or firmness on palpation
• Intermittent pain or painless growth
• Minor bleeding or non-healing lesion at site

• Sthānīya Granthi/Arbuda (Local persistent lump)
• Drudha/Dridha Sparsha (Induration, hard consistency)
• Vrana / Vidradhi (Non-healing ulcer, fungation)
• Raktasrava (Bleeding from lesion)
• Bedha/Pinksa (Fixation to deeper tissues)
• Shotha (Regional swelling/lymphadenopathy)
• Kshayaja lakshana (Weight loss, cachexia)
• Ati-vyathita (Pain unresponsive to simple measures)
• Jwara/Chronic fever
• Organ-specific signs (hemoptysis, jaundice, haematuria etc.)

• Progressive increase in mass size
• Ulceration or fungating wound (vidradhi/vrana)
• Regional lymphadenopathy
• Systemic signs: weight loss, anorexia, fatigue, night sweats
• Organ-specific signs: cough/hemoptysis (lung), dysphagia (esophagus), jaundice (liver), haematuria (urinary tract)

"ग्रन्थिः स्थिरः बलवत् स्फुटिते चेद्दुःखकरः ।"
(सुश्रुत अर्बुद-वर्णनानुसार)

Classical subtypes (mapped):

• Granthi (soft nodular swellings) — early, movable, kaphaja tendencies.
• Arbuda (hard tumour) — dense, fibrotic, often rakta/kapha involvement.
• Gulma (abdominal mass) — involving organ tissues (yakrit/guda/vrikka sambandhi gulma).
• Vidradhi / Vrana (foul ulcerating tumours) — fungating cancers and secondary infections.
• Rakta-Saṃśrita vyadhi (Rakta-dominant tumours) — haemato-lymphatic proliferations analogue.

• Regional and distant metastasis (classical: spread to distant sites, systemic doṣa vikāra)
• Cachexia, ojas-kshaya
• Secondary infections and sepsis
• Organ failure (hepatic, renal, respiratory)

Early, well-defined granthi/arbuda that are localized and do not involve systemic dhatu-kshaya are potentially manageable (sadhya/krichra-sādhya). Advanced, fungating, metastatic tumours with ojas-kshaya are asadhya in classical prognosis. Modern oncology offers curative, palliative or supportive options based on stage.

Treatment principles (Ayurveda-dominant, integrative): remove nidāna, local management of mass, srotoshodhana, rakta-shodhana where indicated, śamana-aushadhi, rasayana, surgical excision where classical/modern indicated, and supportive palliative measures for advanced disease.

• Local surgical / classical excision: Suśruta describes excision and cauterisation of arbuda/granthi with proper shastra-kriya; modern surgical oncology for resectable tumours remains cornerstone.
• Rakta Mokṣaṇa: Leech therapy (Jalauka) or controlled phlebotomy in select Rakta-saṃśrita conditions (classical caution & modern contraindications must be respected).
• Panchakarma:
  • Snehana (external & internal) judiciously used pre- and post-operatively as per classical sequence.
  • Virechana — for Pitta/Rakta dominant local inflammation when indicated.
  • Basti (Anuvasana & Niruha) — to balance Vata and clear medovaha srotas, supportive in cachexia and reconstruction phases.
  • Raktamokṣaṇa — only after strict indication and multidisciplinary clearances.
• Herbal & classical medicines (Śamana/Rasāyana) — selected examples with classical backing:
  • Triphala — srotoshodhaka, mild detoxifier, adjuvant for wound healing.
  • Turmeric / Haridra (Curcuma longa) — anti-inflammatory, wound healing; classical use for vrana & modern adjunct for chemopreventive properties.
  • Guduchi (Tinospora cordifolia) — rasayana, immunomodulatory.
  • Ashwagandha (Withania somnifera) — adaptogen, supportive in cachexia & fatigue; modern evidence supportive as adjunct to chemo for quality of life.
  • Guggulu & Triphala Guggulu — medohara/lekhan properties in early proliferative lesions.
  • Arkapushpadi / Raktachandana based lepa for local application (classical topical measures).
  • Rasaoushadhis (with great caution) — where classical texts prescribe in chronic stubborn lesions; must be used only by qualified practitioners with monitoring.
• Local therapies: Kshara application (ksharasutra-like principles) for accessible superficial granthis/arbuda in classical practice (modern equivalents: cryotherapy, cauterisation), topical lepa, avagāha (sitz baths) with decoctions for ulcerated lesions.
• Palliative & supportive care: Pain management (classical opiates noted in compendia + modern analgesia), management of infection, wound care, nutritional support and rasayana to restore ojas.
• Integrative modern oncology coordination: Where indicated combine surgery, chemotherapy, radiotherapy, targeted therapy & immunotherapy with Ayurvedic supportive regimens — always under multidisciplinary oversight. Ayurveda can contribute to symptom control, reduction of side-effects (nausea, fatigue), improved immunity & quality-of-life with agents like Ashwagandha, Guduchi, and adaptogenic rasayanas.
• Preventive & chemo-preventive measures: Lifestyle correction, smoking & alcohol cessation, dietary modification (reduce processed/red meat, charred foods), increased fruits/vegetables, sun-protection, HPV/HBV vaccination where available, occupational safety to reduce exposure to carcinogens, and weight management.

• Fresh, light, easily digestible foods; emphasis on bitter & astringent vegetables, whole grains
• Adequate protein from plant & lean sources for wound healing
• Hydration & warm liquids; turmeric decoction for local vrana adjunct care

• Smoking, chewing tobacco, betel quid
• Excess alcohol
• Processed meats, charred foods, high-salt preserved foods
• Occupational exposures without protection (asbestos, benzene, aromatic amines)

Modern oncology defines cancer as uncontrolled cell proliferation with ability to invade and metastasize. Key modern risk factors: tobacco, alcohol, ionizing radiation, UV, infectious agents (HPV, HBV, HCV, H.pylori), obesity, sedentary lifestyle, dietary carcinogens (processed/red/charred meat), environmental/occupational carcinogens (asbestos, benzene), and genetic predispositions (BRCA, Lynch syndrome). Tumour biology (oncogenes, tumor suppressor loss, angiogenesis, immune evasion) explains progression and therapeutic targets. Integrative care combines evidence-based oncology with Ayurveda supportive measures to improve tolerance & quality-of-life.

• Histopathology (biopsy) — definitive diagnosis
• Imaging — ultrasound, CT, MRI, PET-CT for staging
• Blood tests — CBC, LFT, RFT, tumor markers where applicable
• Molecular profiling / IHC for targeted therapies
• Baseline nutrition & metabolic assessment