Case Study: Mr. Fan, Ewing-like Sarcoma Treated With TCM
Mr. Fan, born September 1992, male. On February 23, 2017, when I was invited to Hangzhou to see patients, Mr. Fan came from Shanghai to Hangzhou to meet me for the first time, referred by one of my patients.
The patient is a native of Zhejiang, long resident in Shanghai.
On September 27, 2016, the patient sought care for pain in the left hip and was found to have a pelvic mass; biopsy pathology showed malignancy (Ewing-like sarcoma). PET-CT at the Shanghai PLA 411 Hospital (image no. 16100917) showed a soft-tissue mass on the left pelvic wall with adjacent bone destruction and increased FDG uptake, consistent with malignancy, size 12 cm x 9.5 cm, most likely synovial sarcoma or fibrosarcoma.
Neuron-specific enolase and ferritin were abnormal. The patient then went to the Shanghai Proton and Heavy Ion Hospital for carbon-ion radiotherapy.
Referred by a fellow ward patient, the patient decided to seek treatment from me.
Because the patient's family was well-off and he was very young, and we were strangers, I was quite hesitant and unwilling to take the case, fearing that if treatment failed and his disease progressed, the family would make trouble for me. I therefore declined, suggesting his father seek a more famous TCM anti-cancer expert, and recommended some well-known ones.
But his father earnestly insisted I treat him. I remained reserved and, unwilling to prescribe decoction, hoped this would be a polite refusal.
After lunch that day I took the pulse: right pulse wiry, slippery and forceful; left pulse slippery. The patient coughed; tongue coating scorched black; bad breath. He reported lifelong belching and constipation. I therefore suggested he buy the following patent medicines:
Shugan Hewei Wan (Beijing Tongrentang, to move the bowels and stop belching)
Juhua Huatan Wan (Beijing Tongrentang; sputum is scant; stop once cough ceases)
Fufang Banmao Jiaonang (Guizhou Yibai, anti-cancer and resolving masses, twice a day, 3 capsules each time)
Xihuang Wan (Beijing Tongrentang, anti-cancer and resolving masses)
Shenqi Shiyiwei Keli (Shangao Pharmaceutical, to support upright and nourish blood)
March 8, 2017
When invited to Yiwu to see patients, the patient's father again earnestly asked me to go to the family's Shanghai home to treat his son.
On the morning of the 8th, at the patient's home, I took his pulse on an empty stomach: right cun and guan slippery, rapid and forceful, strong on both light and heavy pressure; right cun deep and fine. Left cun and guan deep, slippery and soft; chi pulse deep and fine. Tongue coating white and greasy; many teeth marks on the tongue edges. No lunulae on any of the ten fingernails; nails dark red.
This consultation was detailed. I learned that from childhood the patient had severe constipation: the stool begins in pellet form and later becomes loose—hard at first, then loose. With slight irritation the stomach and intestines readily become constipated or diarrheal.
The bowels often become gassy. The patient has difficulty falling asleep but, once asleep, dreams little.
The family planned chemotherapy plus TCM.
The patient previously did not tolerate chemotherapy, with the main reactions being vomiting, fatigue and exhaustion; he sweated profusely right after chemotherapy. Earlier, after a diagnosis by an old TCM physician, he had taken Huanshao Dan (ingredients mainly including Shanyao [Dioscorea], Roucongrong [Cistanche], Niuxi [Achyranthes], Xiaohuixiang [Foeniculum], Fuling [Poria], Shichangpu [Acori Tatarinowii Rhizoma], Chuzi [Broussonetiae Fructus], Shudi [processed Rehmannia], Duzhong [Eucommia], Gouqi [Lycium], Dazao [Jujube], Bajitian [Morinda]); after heavy-ion therapy, on Western medical advice he stopped the Chinese medicine.
Before illness, the patient's hands and feet would tingle, even tremble, when slightly excited; when not excited, this did not occur.
After chemotherapy the thigh felt itchy, but scratching gave no sensation.
Before illness, after eating crabs once, his leg suddenly would not move and he needed a wheelchair; examination then revealed the Ewing-like sarcoma. Currently, after chemotherapy and heavy-ion radiotherapy, the numb area is shrinking, but the tumor remains.
He has always belched easily, sometimes dry-heaves, and feels stomach bloating with gas; passing flatus releases much gas. As a child he often had tics and constantly needed to clear his throat.
I still had reservations and dared not give such a rich young man harsh, tiger-and-wolf anti-tumor medicinals. I considered a modified Huangqi Guizhi Wuwu Tang combined with Gan Mai Dazao Tang and Guipi Wan:
Sheng Huangqi 30g, Sheng Baizhu 30g, Suanzaoren 30g, Muxiang 10g, Fuxiaomai (immature wheat) 30g, Zhi Gancao 10g, Dazao 10 pieces, Shashen 15g, Taizishen 15g, Dangshen 15g, Yuanzhi 10g, Fuling 30g, Zhuling 30g, Shengjiang 20g, Guizhi 15g, Baishao 15g, Danggui 15g, Chenpi 10g, Fa Banxia 10g, Dan Nanxing 10g, Huainiuxi 10g, Zhi Chuanwu (processed Aconiti) 10g, Zhi Caowu (processed Aconiti Kusnezoffii) 10g, Zhuru (Bambusae Caulis in Taeniam) 30g, Tianzhuhuang (Bambusae Concretio Silicea) 10g, Shidi (Kaki Calyx) 10g, Xuanfuhua (Inulae Flos) 10g (wrap), Jiao Sanxian each 10g, Zaojiaoci (Gleditsiae Spina) 6g, Pian Jianghuang 6g, Chao Jiangcan 10g, Chanyi 6g.
One dose a day, decocted twice, taken in three divided doses, one hour after meals.
Decocting method: soak the herbs in purified or mineral water for 15 minutes, with the water level 1–2 cm above the herbs. Bring to a simmer over low heat, then boil over high heat until about one bowl remains; decoct twice, combine the two decoctions, and take in three divided doses.
I told him the possible effects: improved sleep, improved belching, improved leg numbness, improved bowel movements, improved tongue coating and teeth marks, and tumor shrinkage.
Possible side effects: worse sore throat, worse cough, "heating fire," constipation.
Patent medicines:
Xihuang Wan, once a day, 6–9–12g.
Fufang Banmao Jiaonang, twice a day.
Pingxiao Pian, three times a day, 4–8 tablets.
Yangyin Qingfei Wan.
How to take the patent medicines: starting from the next dose, use Xihuang Wan and Fufang Banmao together; if no obvious side effects in five days, stop two days and then add Pingxiao Pian, starting at 4 tablets each time; if no side effects, increase to 6 tablets the next day, and to 8 tablets on the third day.
Possible side effects of Pingxiao Pian include some neurotoxic effects: limb numbness, oral numbness, dizziness and vomiting, even shock.
Possible side effects of Fufang Banmao include skin rash, mouth ulcers, nausea and vomiting, and increased or decreased urination.
I explained the side effects in great detail, only so that the patient would not panic if they appeared.
Western medicines:
Trimebutine maleate tablets.
Oryzanol; vitamins B1 and B12.
Side effects of trimebutine: dry mouth and constipation.
Side effects of oryzanol: mainly hair loss and weight gain.
Dietary restrictions: seafood, shrimp, crab, pickles, egg yolk and other high-cholesterol foods, beans and other gas-producing foods, spicy-hot food, all chicken, carp, citrus/orange fruit, tea, coffee, alcohol, tobacco; minimize sugar.
March 18, 2017, Beijing, fasting follow-up
The patient's father decided to bring him to Beijing to stay near my home for a while so I could adjust the prescriptions. Seeing his sincerity, though I still felt under pressure, I considered that nearby treatment made observation easier and allowed prompt adjustment if side effects appeared, so I made the medication somewhat more aggressive.
That day the patient's rhinitis flared; pulse slippery, rapid and forceful; tongue coating yellow and greasy with teeth marks. Much sputum and much nasal discharge. I decided to treat the rhinitis first. Judging from the pulse, I diagnosed lung heat and prescribed a modified Mahixinggan Tang (Ephedra, Apricot Kernel, Gypsum and Licorice Decoction).
Sheng Shigao (raw gypsum) 30g (decoct first), Zhi Mahuang (honey-fried Ephedra) 6g, Xingren (Armeniacae Semen) 6g, Zhi Gancao 10g, Zisuye (Perillae Folium) 6g, Zisugeng (Perillae Caulis) 6g.
Xihuang Wan once a day, 6g each time, at bedtime.
Xiaojin Wan once a day, 6g each time, in the morning.
Fufang Banmao Jiaonang, twice a day.
Neixiao Gongliu San (my self-designed formula, later made into pills), twice a day, one sachet each time.
Morning of March 19, Beijing, in my study, fasting follow-up
After the above formula, the rhinitis was basically gone; pulse fine and rather weak.
Decoction:
Sheng Huangqi 30g, Sheng Baizhu 30g, Suanzaoren 30g, Muxiang 10g, Fuxiaomai 30g, Zhi Gancao 10g, Shashen 15g, Taizishen 15g, Dangshen 15g, Yuanzhi 10g, Fuling 30g, Zhuling 30g, Guizhi 15g, Baishao 15g, Danggui 15g, Chenpi 10g, Huainiuxi 10g, Zhuru 30g, Shidi 10g, Xuanfuhua 10g (wrap), Jiao Sanxian each 10g, Zaojiaoci 6g, Pian Jianghuang 6g, Chao Jiangcan 10g, Chanyi 6g.
Fufang Banmao Jiaonang, twice a day, 3 capsules; Neixiao San, 2g each time.
Xiaojin Wan, once in the morning, 6g.
Xihuang Wan, once at bedtime, 9g.
Neixiao Gongliu San (my self-designed formula, later made into pills), twice a day, one sachet each time.
I told the patient to watch whether the tumor site became painful after taking the medicine; if so, that should be regarded as effective.
After taking the medicine, the leg ached slightly, like nerve-compression pain; the lesion site was slightly painful, tolerable. More sputum after dosing, green in color; nasal discharge also green. Two bowel movements, larger than usual, formed; urination normal, rather yellow. Belching slightly reduced; after taking Xihuang Wan-type medicines there is some belching. Mild abdominal bloating.
Morning of March 20, Beijing, in my study, fasting follow-up
Left cun and guan wiry and fine, stronger than yesterday; left chi deep and weak.
Right cun and guan wiry, stronger than yesterday; right chi deep and weak.
Teeth-marked tongue; after stopping Mahixinggan Tang the rhinitis recurred.
Sheng Huangqi 30g, Sheng Baizhu 30g, Suanzaoren 30g, Muxiang 10g, Fuxiaomai 30g, Zhi Gancao 10g, Shashen 15g, Taizishen 15g, Dangshen 15g, Yuanzhi 10g, Fuling 30g, Zhuling 30g, Guizhi 15g, Baishao 15g, Danggui 15g, Chenpi 10g, Huainiuxi 10g, Zhuru 30g, Shidi 10g, Xuanfuhua 10g (wrap), Jiao Sanxian each 10g, Zaojiaoci 6g, Pian Jianghuang 6g, Chao Jiangcan 10g, Chanyi 6g, Fa Banxia 10g, Dan Nanxing 10g, Tianzhuhuang 10g, Zhi Mahuang 6g, Sheng Shigao 30g, Xingren 6g, Zhi Gancao 10g, Zisuye 6g, Zisugeng 6g.
Xiaojin Wan, once in the morning, 6g.
Xihuang Wan, once at bedtime, 12g.
Pingxiao Pian, three times a day, 4 tablets each time.
Fufang Banmao Jiaonang, twice a day, 3 capsules each time.
Neixiao Gongliu San (my self-designed formula, later made into pills), twice a day, one sachet each time.
After dosing, slight pain at the tumor site and slight stabbing pain in the leg; complexion quite good.
No other discomfort.
Morning of March 21, in my study, fasting follow-up.
Left pulse even and moderate, slightly soft; right pulse even and moderate, slightly soft. Complexion good. Tongue coating yellow and greasy, teeth-marked.
Sheng Huangqi 30g, Sheng Baizhu 30g, Suanzaoren 30g, Muxiang 10g, Fuxiaomai 30g, Zhi Gancao 10g, Shashen 15g, Taizishen 15g, Dangshen 15g, Yuanzhi 10g, Fuling 30g, Zhuling 30g, Guizhi 15g, Baishao 15g, Danggui 15g, Chenpi 10g, Huainiuxi 10g, Zhuru 30g, Shidi 10g, Xuanfuhua 10g (wrap), Jiao Sanxian each 10g, Zaojiaoci 6g, Pian Jianghuang 6g, Chao Jiangcan 10g, Chanyi 6g, Fa Banxia 10g, Dan Nanxing 10g, Tianzhuhuang 10g, Chaihu 10g, Huangqin 10g, Zhi Chuanwu 5g, Zhi Caowu 5g, Taoren 10g, Honghua 6g, Shu Dahuang (processed Rheum) 10g (add later).
Xiaojin Wan, once in the morning, 6g.
Xihuang Wan, once at bedtime, 12g.
Pingxiao Pian, three times a day, 6 tablets each time.
Fufang Banmao Jiaonang, twice a day, 3 capsules each time.
Neixiao Gongliu San, twice a day, one sachet each time.
Morning of March 22, in my study, fasting follow-up.
Before taking the decoction yesterday he had one loose, pasty stool, not much in volume. After the decoction, much flatus. Pain level after dosing was about the same as the previous two days.
Left pulse even and moderate; right pulse even and moderate. Complexion good. Tongue coating yellow and greasy, teeth-marked.
Sheng Huangqi 30g, Sheng Baizhu 30g, Suanzaoren 30g, Muxiang 10g, Fuxiaomai 30g, Zhi Gancao 10g, Shashen 15g, Taizishen 15g, Dangshen 15g, Yuanzhi 10g, Fuling 30g, Zhuling 30g, Guizhi 15g, Baishao 15g, Danggui 15g, Chenpi 10g, Huainiuxi 10g, Zhuru 30g, Shidi 10g, Xuanfuhua 10g (wrap), Jiao Sanxian each 10g, Zaojiaoci 6g, Pian Jianghuang 6g, Chao Jiangcan 10g, Chanyi 6g, Fa Banxia 10g, Dan Nanxing 10g, Tianzhuhuang 10g, Chaihu 10g, Huangqin 10g, Zhi Chuanwu 10g, Zhi Caowu 10g, Taoren 10g, Honghua 6g, Shu Dahuang 10g (add later).
Xiaojin Wan, once in the morning, 6g.
Xihuang Wan, once at bedtime, 12g.
Pingxiao Pian, three times a day, 8 tablets each time.
Fufang Banmao Jiaonang, twice a day, 3 capsules each time.
Neixiao Gongliu San (my self-designed formula, later made into pills), twice a day, one sachet each time.
March 25, in my study, fasting follow-up.
After the March 22 formula, no diarrhea; feels gassy; defecation still difficult, with kaiselu needed when constipated.
After stopping medicine, phlegm and cough returned; leg still numb.
Pulse slippery and rapid; tongue coating yellow and greasy, teeth-marked. Spirit good. After several days of conditioning mainly with Guipi Tang, his constitution was better; I decided to advance the medication.
Pugongying root 30g, Rendongteng 30g, Tiankuizi 15g, Yejuhua 15g, Diding 15g, Pian Jianghuang 6g, Chao Jiangcan 10g, Chanyi 6g, Sheng Dahuang 10g (add later), Xuanshen 15g, Zhebeimu 15g, Sheng Muli 30g (decoct first), Fa Banxia 10g, Dan Nanxing 10g, Zhi Chuanwu 10g, Zhi Caowu 10g, Taoren 10g, Honghua 6g, Haizao 30g, Kunbu 30g, Xiakucao 10g, Huainiuxi 10g, Dilong (Pheretima) 10g, Shuizhi (Hirudo) 6g, Zhuru 15g, Tianzhuhuang 10g, Shidi 10g, Jiao Sanxian each 6g, Zaojiaoci 6g, Sanleng 6g, Ezhu 6g, Qianghuo 6g, Duhuo 6g, Mohan Lian 15g, Nüzhenzi 15g, Sheng Huangqi 30g, Baishao 10g, Mudanpi 10g, Xiaoji 30g, Daji 30g.
One dose a day, decocted twice, taken in three divided doses.
Xiaojin Wan, once in the morning, 6g.
Xihuang Wan, once at bedtime, 12g.
Pingxiao Pian, three times a day, 8 tablets each time.
Fufang Banmao Jiaonang, twice a day, 3 capsules each time.
Neixiao Gongliu San, twice a day, one sachet each time.
After taking 12g of Xihuang Wan on the 25th, stomach discomfort; still uncomfortable on the morning of the 26th.
After dosing, belching stopped; much white sputum, no longer green as before.
Much downward qi after dosing. Teeth-marked tongue; the yellow greasy coating has somewhat eased.
March 26, in my study, fasting follow-up.
Left pulse soft, deep, slow and even; right pulse soft, deep, slow and even.
Pugongying root 30g, Rendongteng 30g, Tiankuizi 15g, Yejuhua 15g, Diding 15g, Pian Jianghuang 6g, Chao Jiangcan 10g, Chanyi 6g, Sheng Dahuang 10g (add later), Xuanshen 15g, Zhebeimu 15g, Sheng Muli 30g (decoct first), Fa Banxia 10g, Dan Nanxing 10g, Zhi Chuanwu 10g, Zhi Caowu 10g, Taoren 10g, Honghua 6g, Haizao 30g, Kunbu 30g, Xiakucao 10g, Huainiuxi 10g, Dilong 10g, Shuizhi 6g, Zhuru 30g, Tianzhuhuang 10g, Jiao Sanxian each 6g, Zaojiaoci 6g, Sanleng 6g, Ezhu 6g, Qianghuo 6g, Duhuo 6g, Mohan Lian 15g, Nüzhenzi 15g, Sheng Huangqi 30g, Baishao 10g, Mudanpi 10g, Xiaoji 30g, Daji 30g, Shengdi 12g, Danggui 12g, Chuanxiong 12g, Juhong (Citri Exocarpium Rubrum) 10g, Fuling 20g, Sheng Baizhu 20g, Dangshen 20g, Haifushi 30g (decoct first), Tusizi 10g, Shayuanzi 10g.
One dose a day, decocted twice, taken in three divided doses.
Xiaojin Wan, once in the morning, 6g.
Xihuang Wan, once at bedtime, 12g.
Pingxiao Pian, three times a day, 8 tablets each time.
Fufang Banmao Jiaonang, twice a day, 3 capsules each time.
Neixiao Gongliu San, twice a day, 2g each time.
On the evening of the 26th, after 12g of Xihuang Wan, stomach discomfort.
March 27, in my study, fasting follow-up.
The yellow greasy coating had improved considerably.
Pulse moderate and forceful, even; right pulse slightly wiry.
Pugongying root 30g, Rendongteng 30g, Tiankuizi 15g, Yejuhua 15g, Diding 15g, Pian Jianghuang 6g, Chao Jiangcan 10g, Chanyi 6g, Sheng Dahuang 10g (add later), Xuanshen 15g, Zhebeimu 15g, Sheng Muli 30g (decoct first), Fa Banxia 10g, Dan Nanxing 10g, Zhi Chuanwu 10g, Zhi Caowu 10g, Taoren 10g, Honghua 6g, Haizao 30g, Kunbu 30g, Xiakucao 10g, Huainiuxi 10g, Dilong 10g, Shuizhi 6g, Zhuru 30g, Tianzhuhuang 10g, Jiao Sanxian each 6g, Zaojiaoci 6g, Sanleng 6g, Ezhu 6g, Qianghuo 6g, Duhuo 6g, Mohan Lian 15g, Nüzhenzi 15g, Sheng Huangqi 30g, Baishao 10g, Mudanpi 10g, Xiaoji 30g, Daji 30g, Shengdi 12g, Danggui 12g, Chuanxiong 12g, Juhong 10g, Fuling 20g, Sheng Baizhu 20g, Dangshen 20g, Haifushi 30g (decoct first), Tusizi 10g, Shayuanzi 10g.
One dose a day, decocted twice, taken in three divided doses.
Shenqi Shiyiwei Keli.
Xiaojin Wan, once in the morning, 6g.
Xihuang Wan, once at bedtime, 12g.
Pingxiao Pian, three times a day, 8 tablets each time.
Fufang Banmao Jiaonang, twice a day, 3 capsules each time.
Neixiao Gongliu San, twice a day, 2g each time.
On the evening of the 26th, after 12g of Xihuang Wan, stomach discomfort.
After a week of nearby treatment and observation, I felt I had basically mastered the patient's condition and could let him return home to take the final prescription at his ease, controlling the Xihuang Wan dose. I told him to have a checkup every one to two months.
Thereafter every follow-up showed the tumor shrinking. His Western attending initially urged chemotherapy back, but the patient deeply feared its side effects and refused further Western treatment, insisting on Chinese medicine. Symptoms improved markedly; occasionally he stopped medicine for a while due to stomach discomfort, and if stopped too long discomfort returned, so he resumed.
Treated on and off like this, the tumor steadily shrank. His Western attending, who had been following his progress, seeing the continued shrinkage, said he need not undergo chemotherapy for now and could continue Chinese medicine under observation.
May 8, 2017, the patient returned to Beijing for follow-up.
Tongue slightly greasy, teeth-marked tongue still present.
Pulse moderate and forceful, even.
After stopping medicine, bowels still not quite regular, but belching much better than before.
Leg numbness had improved considerably; slight discomfort at the tumor site.
No other discomfort; consciousness clear.
Pugongying root 30g, Rendongteng 30g, Tiankuizi 15g, Yejuhua 15g, Diding 15g, Pian Jianghuang 6g, Chao Jiangcan 10g, Chanyi 6g, Xuanshen 15g, Zhebei 15g, Sheng Muli 30g (decoct first), Fa Banxia 10g, Dan Nanxing 10g, Taoren 10g, Honghua 6g, Haizao 30g, Kunbu 30g, Xiakucao 10g, Huainiuxi 10g, Dilong 10g, Shuizhi 6g, Zhuru 30g, Jiao Sanxian each 10g, Zaojiaoci 6g, Sanleng 10g, Ezhu 10g, Qianghuo 10g, Duhuo 10g, Mohan Lian 15g, Nüzhenzi 15g, Sheng Huangqi 30g, Baishao 10g, Mudanpi 10g, Xiaoji 30g, Daji 30g, Shudi 10g, Danggui 10g, Chuanxiong 10g, Juhong 10g, Fuling 20g, Sheng Baizhu 20g, Dangshen 20g, Huai Shanyao 30g, Haifushi 30g (decoct first), Tusizi 10g, Shayuanzi 10g, Banzhilian 30g, Tengligen 30g, Shejicao 30g, Xianhecao 30g, Maidong 30g, Tiandong 30g, Guizhi 20g.
One dose taken over two days.
Patent medicines:
Xiaojin Wan, once in the morning, 6g.
Xihuang Wan, once at bedtime, 12g.
Pingxiao Pian, three times a day, 8 tablets each time.
Fufang Banmao Jiaonang, twice a day, 3 capsules each time.
Neixiao Gongliu San, twice a day, 2g each time.
September 19, 2017, follow-up.
At his August checkup the tumor had completely vanished; only edema remained around the former tumor. Since his symptoms lightened, he had gained a good deal of weight; his complexion had improved greatly.
Pulse moderate and forceful; teeth-marked tongue; if medicine is stopped, constipation recurs. Because the tumor grew near the femur and damaged nerves, the leg always has some discomfort. Occasional belching.
Now that the tumor had vanished, treatment should focus on preventing recurrence: fortifying the spleen and kidney, clearing heat and resolving toxin, eliminating edema, and restoring leg function.
Sheng Huangqi 30g, Chao Baizhu 30g, Yun Fuling 30g, Zhi Gancao 10g, Chao Pugongying root 30g, Rendongteng 30g, Zibeitiankuizi 10g, Zihua Diding 10g, Yejuhua 6g, Mohan Lian 30g, Nüzhenzi 30g, Tusizi 30g, Shayuanzi 30g, Mugua 30g, Niuxi 15g, Pian Jianghuang 6g, Chanyi 6g, Chao Jiangcan 10g, Xianhecao 30g, Baihua Shejicao 30g, Tengligen 30g, Banzhilian 30g, Shidi 10g.
Xiaojin Wan, once a day, 6g.
Xihuang Wan, once a day, 6g each time.
Fufang Banmao Jiaonang, twice a day, 3 capsules each time.
Neixiao Gongliu Wan (the powder now made into pills), twice a day, 15 pills each time.
Guipi Wan, twice a day.
I told him to return to Beijing in three months. The effect of this recurrence-prevention treatment awaits further observation.
In terms of outcome, this patient was fortunate. The patient who referred him to me was not so lucky; I was not satisfied with that treatment.
This patient's course was genuinely bumpy. Because his family was well-off, and because TCM anti-cancer effects are so widely criticized, and because tumors are hard to treat and his was very large, I was very conservative at the outset and inwardly hoped to turn him away.
But his father trusted me greatly; especially at that time, when I repeatedly practiced in Zhejiang using large doses and large formulae to rescue severe cases with decent results, his father did not mind my youth and kept insisting I treat his son.
At one point the family considered taking him abroad or to Hong Kong for treatment, but gave up because, seeing decent results, I would not agree to change the medical plan.
Against the current backdrop of strained doctor-patient relations and widespread public distrust of TCM against cancer, it was no small thing that the family trusted me from start to finish.
Incidentally, after so many setbacks in treating tumors over the years, I have deeply felt how difficult medicine is, and so I often use various means to politely decline some seekers. It is truly a last resort.
Many years ago I treated another Ewing sarcoma patient. He had failed treatment at Xiangya Hospital, gone home bedridden, and awaited death when he came to me.
After I wrote a prescription, within only half a month there was striking improvement: the tumor shrank and he could get up and move about.
But later, misled by another bowel-cancer patient, he went for "original point" therapy, drinking large amounts of ginger decoction and using hot compresses—completely opposite to my heat-clearing, toxin-resolving approach. He died in under three months. Before dying he came to see me, deeply regretting his blindness and willfulness.
These two experiences are well worth reflecting on. Whether Chinese or Western, treating cancer is hard; once a regimen works, one should not change it lightly. Doctor-patient relations are fragile, trust is hard to build, and should not be wantonly destroyed.