Case Report: TCM Treatment of a Child Patient Zhou with Neuroblastoma

Neuroblastoma (NB) is known as the king of pediatric tumors and is extremely difficult to treat. Neuroblastoma originates in the sympathetic ganglia or the bilateral adrenal glands; it is the most common extracranial solid tumor of childhood. Epidemiological studies suggest the following factors may promote neuroblastoma: premature infants and low-birth-weight infants; use of sex hormones before or during pregnancy; daily alcohol consumption during pregnancy; and parents of the child working in electronics-related occupations.

At present, the main Western treatments for neuroblastoma are surgery, radiotherapy and chemotherapy. Despite all these means, the cure rate for stage 4 high-risk neuroblastoma children is extremely low. The children I currently see are mainly stage 4 high-risk cases, because generally only stage 4 high-risk patients seek TCM help; earlier-stage children mostly choose Western treatment. Of the stage 4 high-risk children I have seen over the years, none survived after conventional surgery, radiotherapy and chemotherapy, and there are now only a handful of effective TCM cases, showing how extremely difficult this disease is to treat.

This patient, Zhou, female, born February 18, 2010, from Hunan, long resident in Loudi, Hunan, was first seen on July 13, 2018. She had been diagnosed with ganglioneuroblastoma (mixed type) (Beijing Children's Hospital medical record no. 0175288). Two palliative operations had been performed at Beijing Children's Hospital, followed by postoperative chemotherapy. The surgery and chemotherapy achieved tumor reduction, but the tumor burden in the body was still large. Western doctors recommended radiotherapy, judging that given the tumor's growth rate, if the intraspinal tumor were not controlled by radiotherapy, the child would soon be paralyzed. But they also told the parents that radiotherapy carried a risk of paraplegia. The parents did not know how to choose; referred by families of other neuroblastoma patients, they sought my help.

The child had been constipated since infancy, with a bowel movement every seven days, and was developmentally delayed. Between ages one and two, she basically had a high fever once a month, which improved somewhat after antibiotics were given. After age three she seldom fell ill. At four and a half the parents felt her development was off and took her to hospital, but nothing abnormal was found.

In July 2017, the mother found the child had scoliosis, with one shoulder higher than the other. X-rays at the local hospital showed no orthopedic problem. Later, at the provincial children's hospital, a huge abdominal tumor was found; she was seen at Beijing Children's Hospital and underwent debulking surgery—two palliative operations in all—followed by chemotherapy. Complete remission was not achieved; now tumor foci are visible behind the right kidney and between the lumbar muscles, extending into the intervertebral foramina.

Both left and right pulses were soft, weak and slippery-waterish; the tongue was watery-glossy. When little, her stool was like sheep pellets—granular, dry and hard. Now it is formed and strip-like. The child stopped growing hair at a very young age, and the fontanelle closed late.

Prescription from the TCM department of the children's hospital:

Chao Daoya 9 g, Chao Guya 9 g, Chao Jianqu 9 g, Caodoukou 3 g, Sharen 4 g, Jiao Shanzha 9 g, Jineijin 9 g, Huangjiu 9 g, Ejiao 9 g, Gouqi 6 g, Zhi Huangqi 6 g, Sheng Dihuang 9 g, Shu Dihuang 9 g, Nüzhenzi 9 g, Lugen 10 g

Afterward, adjustments were basically made on this basis, with Huaishanyao, Xiancao and others added in turn. After taking the above, the child's appetite and stool improved somewhat, but long-term use became ineffective.

The child had severe night sweats and fever. She felt hot at night, sweating in the first half of the night, with sweating stopping in the second half. She did not like drinking water. Apart from chronic gastroenteritis, the mother had no other diseases; the father was basically healthy. The grandfather died of lung cancer.

TCM pattern differentiation: Biejia Qinghao Tang pattern.

Decoction: Biejia Qinghao Tang combined with Erzhi Wan, modified.

Qinghao 6 g (add later), Zhi Biejia 12 g, Zhimu 6 g, Mudanpi 9 g, Digupi 9 g, Sheng Dihuang 12 g, Mohanlian 10 g, Nüzhenzi 10 g, Fuling 20 g, Zhuling 10 g, Chao Yiyiren 15 g, Jiao Sanxian each 15 g

One dose every two days, taken once in the morning and once in the evening.

Patent medicines: Liuwei Dihuang Wan (Tongrentang), taken at one-third the adult dose; Fufang Banmao Jiaonang (Guizhou Yibai), twice a day, 1–2 capsules each time; Huangqi Jianzhong Tang granules (Japanese Kampo medicine, reserved as backup—if night sweats and similar symptoms do not resolve after the decoction, switch to this). In addition, dozens of herbs including Wugong, Quanxie, Shanqiongchong, Chansu, Niuhuang, Shexiang, Bihu, Tenghuang, Ruxiang, Moyao, Ercha and Xuejie were made into pills for antitumor use.

Second visit, November 2, 2018.

Recent re-examination at Beijing Children's Hospital showed that the previously detected scar tumor focus in the abdomen had shrunk compared with before, while the tumor in the intervertebral foramen showed no obvious improvement. Both left and right pulses were slippery and rapid; the tongue tip was red. The child had a cold with nasal discharge.

Patent medicines given: Ganmao Qingre Keli, Zhenqi Fuzheng Keli, Fufang Banmao Jiaonang, Xihuang Wan, and so on. The parents were also told to grind Xuan Shen 120 g, Chuanbei 100 g, Duan Muli 100 g, Duan Longgu 100 g, Sanleng 60 g, Ezhu 60 g, Liangtoujian 30 g, Haizao 150 g, Kunbu 150 g, and Lu Fengfang 60 g together into a fine powder; twice daily, take 1.5–3 g of powder washed down with a decoction made from 15 g of Xiakucao. The previously used pills were continued.

Third visit, February 16, 2019. Left pulse fine and weak; right pulse fine, weak and rapid; tongue coating white and pale; constipation.

Decoction: modified Huangqi Shengmai Yin.

Sheng Huangqi 30 g, Maidong 6 g, Wuweizi 6 g, Dangshen 15 g, Jiao Sanxian each 10 g, Roucongrong 30 g

Patent medicines: powders and pills basically as before. Ganmao Qingre Keli was removed.

Follow-up, May 22, 2019. Pulse had become moderate; tongue coating basically normal; several tumors were shrinking, except the tumor in the spinal canal foramen. Bowel movement once every several days.

By this time my multi-target anticancer approach with Chinese herbal compounds had achieved fairly obvious results in adult tumor patients, so I decided to apply the same regimen to this neuroblastoma child, but with reduced dosage and fewer herbs. For the medication regimen, see my article My Practical Experience Using Chinese Herbal Compounds for Multi-Target Broad-Spectrum Anticancer Treatment. The child was also told to take probiotics.

Follow-up, August 23, 2019. Bowel movement still once every several days; new lymph nodes in the neck; pulse moderate and slightly rapid. TCM pattern differentiated as Niubang Jieji Tang pattern.

Decoction: Niubang Jieji Tang combined with Jiang San San, modified.

Niubangzi 10 g, Bohe 10 g, Jingjie 12 g, Lianqiao 12 g, Chao Zhizi 10 g, Mudanpi 10 g, Shihu 10 g, Xuanshen 15 g, Xiakucao 10 g, Pian Jianghuang 6 g, Chao Jiangchan 10 g, Chanyi 6 g, Sanleng 6 g, Ezhu 6 g, Maren Wan 20 g

One dose a day, taken once morning and evening.

Patent medicines: treated fully according to the regimen in My Practical Experience Using Chinese Herbal Compounds for Multi-Target Broad-Spectrum Anticancer Treatment, at half the adult dosage.

After the COVID-19 outbreak in 2020, the child could no longer come for follow-up, so treatment was guided remotely and the original regimen continued. Because taking decoction was inconvenient, Niubang Jieji Tang was made into pills according to the original formula. After the pandemic stabilized, the child returned to school and taking medicine twice a day was inconvenient. The parents reduced the number of daily doses to one, taken in the evening after returning home, but increased the dosage. The child was re-examined every three months at Hunan Provincial People's Hospital. On July 23, 2020, examination at Hunan Provincial People's Hospital showed that the intraspinal tumor had shrunk. The child is still under treatment.

Since the initial visit in July 2018, this child has given up all Western treatment and taken only Chinese medicine. Although not yet cured, achieving such results and continuous improvement is no small thing. I believe the child's results are closely related to her not undergoing further radiotherapy and chemotherapy later, which preserved some righteous qi in her body. If she had undergone frequent radiotherapy and chemotherapy, her immunity would have declined and her appetite fallen, and TCM treatment would likely not have produced such good results.

This child's results also prove that researching TCM anticancer treatment with a disease-specific approach is promising. Tumor treatment should grasp the principal contradiction of tumor diseases, value disease-differentiation treatment, and use targeted medication.