Medication Experience in Four Patients with Tumor or Tissue Hyperplasia and a Bleeding Tendency

Several years ago, I saw a patient with ovarian cancer in Putian, Fujian Province. After she developed bloody ascites, guided by a local villager, she foraged fresh Chinese herb Xiaoji (Herba Cephalanoploris) and stewed it into soup to drink. Each time she used about 250-500 g of fresh Xiaoji. After half a month of use, her CA125 dropped significantly; after continuing, the ascites disappeared and CA125 fell to normal.

Today (April 26, 2023), I saw another ovarian cancer patient, a native of Shanxi Province. Her family carries a BRCA gene mutation and has a family history of ovarian and breast cancer; two direct relatives have already died of malignant tumors. Her maternal grandmother died of breast cancer at 67, and her mother died of ovarian cancer at 48. Her aunt (mother's elder sister) had breast hyperplasia a few years ago (already at the benign-malignant borderline); after being diagnosed, the aunt heard that eating Jicai (Capsella bursa-pastoris) could treat breast hyperplasia, so she ate large amounts of it, and the breast hyperplasia actually disappeared.

This ovarian cancer patient was born in 1988 and was diagnosed with ovarian cancer in 2019 at age 31. After diagnosis she received standardized surgery plus chemotherapy and targeted therapy. Postoperatively, apart from a marked CA125 drop during the use of the cytotoxic drug oxaliplatin, other drugs were ineffective. Moreover, when she used the broad-spectrum anti-angiogenic targeted drug bevacizumab, she also developed nosebleeds.

The patient's mother was also an ovarian cancer patient and survived more than three years after diagnosis. In the last three months of her life she took the patent medicine Fufang Banmao Capsule, an anti-tumor-angiogenesis Chinese patent medicine. After three months of use, her mother had bleeding from the mouth and nose and ultimately died unexpectedly of stroke. Because of this painful lesson, when this patient developed epistaxis after starting bevacizumab, she stopped bevacizumab promptly, avoiding further damage.

The medication experience of three members of this patient's family is highly cautionary. TCM treatment of cancer most often relies on blood-activating stasis-resolving herbs or blood-breaking stasis-expelling herbs (such as Sanleng, Ezhu, Ruxiang, Moyao, Shuizhi, Banmao). The anticancer mechanism of these herbs is mainly anti-tumor-angiogenesis, pharmacologically similar to many western targeted drugs (such as bevacizumab). Facts prove that for some patients, such anti-tumor-angiogenesis drugs not only fail to treat the disease but may even be fatal. Therefore not all tumor patients are suitable for treatment with such drugs.

The Jicai used by this patient's aunt is a wild vegetable, an herb of the Brassicaceae family, genus Capsella, with a long history of both food and medicinal use. The Mingyi Bielu (Records of Famous Physicians) records that Jicai harmonizes the spleen, promotes diuresis, stops bleeding and brightens the eyes; it is commonly used for postpartum bleeding and menorrhagia. The Xiaoji used by the Putian ovarian cancer patient is the aerial part of the composite plant Cirsium setosum; Xiaoji is a famous TCM hemostatic, and the famous hemostatic formula Xiaoji Yinzi is named after it. Xiaoji has three major actions: hemostasis, diuresis and abscess-dissipation. The Putian ovarian cancer patient, using Xiaoji alone in soup, achieved a threefold effect: ascites resolved, bleeding was solved, and the tumor marker fell.

Comparing the medication experience of these four patients, it is not hard to see that such bleeding-tendency patients can hardly achieve ideal results when using anti-angiogenic or anticoagulant Chinese and Western drugs; moreover, the side effects of such drugs can endanger their lives. Yet after using traditional medicinal herbs that both stop bleeding and promote diuresis, their condition unexpectedly improved.

The personal experiences of these four patients remind us that tumor patients should be treated individually. Why do such patients have a bleeding tendency? Perhaps some tumor patients have congenital genetic predispositions, so they bleed easily once they develop a tumor. TCM treatment has always been a balancing approach; using hemostatic drugs in bleeding-tendency patients is precisely symptomatic treatment based on the TCM idea of "reducing the excess and supplementing the deficiency."

If we blindly regard tumors as a disease of intermingled phlegm and stasis and treat all patients with blood-activating stasis-resolving or blood-breaking stasis-expelling methods, or with western anti-tumor-angiogenesis targeted drugs, we will inevitably put such patients at risk of death rather than solve their problems.

It follows that individualized treatment of tumor patients is very important. The prerequisite for individualized treatment is that the doctor fully grasps the patient's medical history, family history and drug allergy history; the doctor must also avoid forming prejudices and flexibly adjust his understanding of the disease based on patient feedback. If one falls into a prejudice, believing that tumors must be treated with anti-angiogenic drugs, or from a TCM angle believing that the tumor mechanism must be intermingled phlegm and stasis and must be treated with blood-activating stasis-resolving herbs, one will easily make mistakes.