It Is Best Not to Have Cancer Patients Take Herbal Decoctions Long-Term
Although I have repeatedly mentioned in many articles that cancer patients should avoid taking herbal decoctions long-term, I still want to write a dedicated piece to emphasize this and to raise awareness among patients and their families.
It is true that the medical records of many famous physicians contain a few cases of cancer patients cured after taking decoctions (and I often share such cases), but long-term use of decoctions is not an ideal choice for the vast majority of cancer patients. Moreover, relative to the total number of cancer patients a physician treats over a lifetime, the proportion of cured cases is so small as to be almost negligible. Even for a great anti-cancer physician like Sun Bingyan, the proportion of cancer patients with exceptionally excellent outcomes was probably only a few percent; most of the other patients endured great suffering and severe drug side effects during their months on decoctions.
Patients or their families often send me links to articles praising today's great TCM masters. Over the past ten to twenty years, I have had real contact with many of the masters mentioned in these articles and with the patients they treated. Honestly, the patients on whom they failed or who developed severe side effects far outnumber those they cured.
I can say responsibly that more than 90% of such articles are exaggerated. Some self-media outlets' exaggerated descriptions of deceased TCM masters (such as Li Ke) would truly make those masters turn red with shame in their graves; if they returned to life and saw such articles, they would surely be very displeased. From what I know, the masters themselves never dared to brag so recklessly. Such articles are hype by marketing accounts, abetted knowingly or unknowingly by irrational TCM fans.
Based on my years of experience and observation, for most cancer patients the drawbacks of long-term herbal decoction use outweigh the benefits, and this approach also violates the fundamental spirit of traditional Chinese medicine. Traditional TCM preparations come in many forms; besides decoctions, the most common are pills, powders, plasters, and pellets. In ancient times, TCM physicians mainly used pills, powders, plasters, and pellets rather than decoctions for chronic diseases.
TCM has a saying: "A decoction is for sweeping away" emergencies. The decoction brewed from herbs is used to treat acute conditions, generally for a short course of as little as one or two days or as much as one or two weeks, after which the patient recovers; under such conditions a decoction may be chosen. If this is not the case and treatment is needed year after year, one must consider replacing the decoction with pills, powders, plasters, or pellets. TCM has another saying: "Pills act slowly." Chronic diseases require gradual treatment, and pills are more suitable.
The vast majority of cancer patients I have dealt with have complained to me about how foul-tasting herbal decoctions are. When my mother was alive, let alone drinking the medicine, even smelling the decoction from dozens of meters away made her nauseous. It is normal for patients to feel this way; it is not that there is something wrong with the patient, but that herbal decoctions genuinely taste awful. When some patients develop physiological reactions after drinking the medicine (such as nausea or loss of appetite), it is not necessarily because some ingredient causes the side effect; it is simply a normal conditioned reflex. The most miserable patients I have seen are those who, after taking decoctions continuously for a year without a break, could barely even swallow water, and ultimately had to rely on nutrient infusions to maintain basic energy metabolism.
The most stubborn family members (and a few patients themselves) insist that only drinking herbal decoctions counts as treating disease with Chinese medicine, and they reject various Chinese patent medicines. I sometimes jokingly say to the accompanying family member: "Tell me what discomforts you have, and I'll prescribe a month of decoction; go home and drink it for a month, then decide whether to keep insisting that your loved one take herbal decoctions." Some family members lack empathy for the patient, cannot understand the suffering of drinking decoctions, and instead think the patient is being delicate.
Long-term use of decoctions for chronic disease is a strange phenomenon that has appeared only in recent decades, and it is tied to the constraints that the old TCM administration law imposed on TCM. The new TCM law has even taken this into account and relaxed controls over the preparation forms used by TCM medical institutions. In other words, it is an error created by outdated law, not a historical tradition. Once this trend arose, patients and families, under herd psychology, took for granted that TCM treatment consists only of acupuncture and decoctions.
Sometimes even when I suggest patients use Chinese patent medicines such as Xihuang Wan, Erchen Wan, or Liujun Wan, the patients and their families hear the names and tell me: "I won't take Western medicine; I want Chinese medicine." This makes me feel rather sad: we Chinese are now so ignorant of our own medicine that we regard these time-honored herbal pills as Western medicine. In their minds, only the water decocted from raw herbal pieces prescribed by a TCM physician counts as Chinese medicine; everything else is Western medicine.
Historically, a TCM physician specializing in a particular department would keep on hand the pills, powders, plasters, and pellets commonly used in that specialty and prescribe them to patients as needed. Most famous herbal pills, powders, plasters, and pellets are also produced by modern Chinese patent medicine factories, and their quality may be more reliable than the raw herbal pieces sold in pharmacies. Pills, powders, plasters, and pellets are far more convenient to take than decoctions, are less unpleasant for the patient, and are more suitable for long-term treatment.
Cancer treatment courses are long, and some patients may even need medication for life. Neither TCM nor Western treatment of cancer ends within a week or two. The most common outcome when these patients long-term take herbal decoctions is that they ruin their stomach, liver, and kidneys. Because pills, powders, plasters, and pellets use smaller doses than decoctions, they are safer and rarely cause severe side effects. In fact, not only cancer patients but those with stroke sequelae, chronic bronchitis, and various other chronic diseases are also better treated with pills, powders, plasters, and pellets.
In fact, the ideal TCM approach to cancer is a combination of pills, powders (powders can be enclosed in capsules or self-filled into capsules for easier taking), and plasters. Many famous anti-cancer TCM formulas are already produced as ready-made pills, tablets, or capsules, such as Xihuang Wan, Xiaojin Wan, Pingxiao Pian, Fufang Banmao Jiaonang, and Weimaining Jiaonang. Such medicines are convenient to take and are covered by medical insurance in many places, making them a more economical choice for patients than decoctions.
Some pills can also be self-made according to a prescription. Making herbal pills is not very difficult; the simplest method requires only a winnowing tray and can be done by hand. Video sites (such as Bilibili) have video courses teaching how to make herbal pills. If family members want to save money and make pills such as Xihuang Wan themselves, they can entirely follow these tutorials and published prescriptions.
But each patient has individual differences, so if the prescribing physician can, based on those differences, also prescribe some powders (for example, grinding insect herbs such as wugong (centipede), xiezi (scorpion), and bihu (gecko) into a powder), letting the patient buy empty capsules and fill them himself, then combining fixed pills with individualized powders will be much better.
Some root-and-bark herbs are not suitable for pills or powders; these can be made into a plaster for the patient. Based on the patient's symptoms, the physician may first prescribe some decoction for a period (1-4 weeks) and observe the response. If effective, the prescription can be modified and the patient can self-prepare a plaster. This short initial decoction course is generally called the "opening-path formula" (kailu fang), a trial prescription to determine the therapeutic direction for the plaster.
Plasters come in two types: external and oral. External plasters are the various medicinal patches we commonly stick on the body surface; making them is often cumbersome, so ready-made patent medicines such as Chanu Babu Gao may be considered.
An oral plaster is a single large prescription that the patient takes home, decocts in a large pot 2-4 times, collects the combined decoction, and then simmers it over low heat until it thickens into a semi-solid, adding an appropriate amount of honey, brown sugar, or Ejiao (donkey-hide gelatin) powder to form the plaster. It is stored in a sealed bottle in the refrigerator. Take 2-3 times daily, each time about 5-15 ml, taken directly or dissolved in hot water. In this way each dose is only one-tenth or even less of a decoction dose, the medicine goes down far less unpleasantly, and side effects are much smaller.
A plaster is suitably made as a 1-2 month supply; after 1-2 months the patient can return for follow-up and receive a new plaster prescription based on changes in the condition. For example, if a cancer patient has poor blood-count indicators and they improve markedly after a period on the plaster, it may no longer be necessary to continue the blood-count-improving plaster.
Combining pills, powders, plasters, and pellets can significantly reduce the treatment cost for cancer patients. Some patients on decoctions spend thousands or even tens of thousands of yuan a month (unscrupulous TCM physicians can even cost patients tens of thousands a month), but after switching to the pill-powder-plaster combination, side effects drop greatly and costs fall substantially. Cancer is a chronic disease. The more medical common sense patients and families learn, and the more basic skills they master (such as making pills and boiling plasters), the more it will help the patient's recovery and lighten the family's financial burden.