A Clinical Case: A Patient with Lymphoma, Hepatitis B, and Diffuse Hepatic Lesions

This is a case I treated with pure TCM in 2016. After more than half a year of treatment, the patient's condition was controlled quite satisfactorily, so I am organizing the case record for colleagues' reference and correction.

The patient, Qi, male, 45, from Liaoyuan, Jilin, had a family history of hepatitis B. His mother was also a hepatitis B patient who progressed to liver cancer. After his mother was diagnosed with liver cancer, she received Western treatment but survived only a short time with poor quality of life; these left a deep impression on the patient. Therefore, after his own diagnosis of lymphoma, he resolved to use pure TCM treatment, and on his own even decided to stop Western anti-hepatitis-B drugs such as entecavir.

On August 18, 2015, the patient underwent PET-CT at the Second Artillery General Hospital of the People's Liberation Army (CT no. 15081818). Imaging showed a tumor lesion in the groin. There was also a possible cerebral infarct focus. Chronic inflammatory changes in both maxillary sinuses, emphysema in both lung apices, mild fatty liver, possible gallstones, and calcification in the prostate were noted.

On August 21, 2015, a pathology consultation opinion from the Pathology Department of Beijing Friendship Hospital, Capital Medical University, and the Lymphoma Diagnosis and Research Center of the Beijing Institute of Clinical Medicine showed partial destruction of the left inguinal lymph node, with scattered lymphoid follicle structures; the mantle zones of some follicles were prominent, and there was infiltration of many small lymphocytes between follicles. The lymphocytes had relatively abundant, pale-staining cytoplasm; some nuclei were irregular, with moderate chromatin and indistinct nucleoli, and mitotic figures were visible. Pathological diagnosis: low-grade non-Hodgkin B-cell lymphoma of the left inguinal lymph node, favoring marginal zone B-cell lymphoma.

On February 19, 2016, a CT at the Jilin Provincial Hepatobiliary Disease Hospital (CT no. 160712) showed signs of cholecystitis, liver cirrhosis, and splenomegaly. Blood tests at the same hospital on the same day showed alpha-fetoprotein (Roche) at 277.900 (reference range 0.000–7.000), with abnormal liver function; transaminases and bilirubin were elevated.

In mid-to-late February 2016, after completing examinations at the Jilin Provincial Hepatobiliary Disease Hospital, the patient came to Beijing to see me. He was accompanied by two family members. I and his family advised integrated Chinese-Western treatment, but the patient refused, demanding pure TCM treatment.

Before the first visit, the patient had already sought treatment from various quarters for some time. Illness plus a fright had left his general condition poor. His pulse was wiry, and the coating yellow and greasy. I judged that his constitution was still adequate to tolerate attack treatment. I decided on a comprehensive approach: soothe the liver and resolve depression, fortify the spleen, clear heat and detoxify, soften hardness and disperse nodules, and activate blood and resolve stasis. The initial prescription:

Chaihu (Bupleurum) 10 g, Huangqin (Scutellaria) 10 g, Baizhu (Atractylodes) 20 g, Fuling (Poria) 20 g, Danggui (Angelica) 20 g, Baishao (White peony) 20 g, Huaishanyao (processed Dioscorea) 20 g, Lianqiao (Forsythia) 20 g, Wuweizi (Schisandra) 15 g, Yinchen (Artemisia capillaris) 20 g, Chao Zhizi (fried Gardenia) 15 g, Sheng Gancao (raw licorice) 15 g, Danshen (Salvia) 40 g, Sheng Huangqi (raw Astragalus) 15 g, Baihua Sheteng (Oldenlandia) 30 g, Banzhilian (Scutellaria barbata) 20 g, Haifushi (pumice) 20 g (decoct first), Ezhu (Curcuma zedoaria) 10 g, Sanleng (Sparganium) 10 g, Tengligen (Actinidia root) 30 g, Jiangcan (Bombyx batryticatus) 10 g, Jianghuang (Curcuma longa) 6 g, Chanyi (cicada slough) 6 g, Xiakucao (Prunella) 15 g, Xuanshen (Scrophularia) 15 g, Zhe Beimu (Fritillaria thunbergii) 15 g, Sheng Muli (raw oyster shell) 30 g (decoct first).

Decoct in water; one dose daily, divided into three doses taken one hour after meals. Take for one week, then stop for one week.

Patent medicines additionally:

1. Pingxiao Pian, once each morning, at the dose on the package insert.

2. Xihuang Wan, once each evening: 3 g on day 1, 6 g on days 2–3, 9 g on days 4–5, 12 g on days 6–7.

As with the decoction, take for seven days, then rest seven days.

Western medicine: domestic thymosin, injected every other day.

Diet therapy: adhere to coix seed (yimi) porridge.

Exercise: adhere to jogging plus brisk walking.

After one month of medication, the patient returned to the Liaoyuan TCM Hospital for a B-ultrasound follow-up. The inguinal lymphomas on both sides had all shrunk considerably, from over 3 cm to just over 2 cm. I told him to continue the medicine. After a little over a month, a repeat exam showed the tumors had shrunk further on top of the previous reduction. Liver function had fully returned to normal, and alpha-fetoprotein was basically normal. During this period the patient had also taken anti-hepatitis-B antiviral medication.

On May 21, the patient returned. The pulse was no longer wiry but slightly weak; the tongue was basically normal, and his energy was good. There was slight drug-related liver damage. I adjusted the prescription, with the basic approach unchanged:

Chaihu 10 g, Huangqin 10 g, Baizhu 20 g, Fuling 20 g, Danggui 20 g, Baishao 20 g, Huaishanyao 20 g, Lianqiao 20 g, Wuweizi 15 g, Yinchen 20 g, Chao Zhizi 15 g, Sheng Gancao 15 g, Danshen 40 g, Sheng Huangqi 15 g, Baihua Sheteng 30 g, Haifushi 20 g (decoct first), Ezhu 10 g, Sanleng 10 g, Tengligen 30 g, Jiangcan 10 g, Jianghuang 6 g, Chanyi 6 g, Xiakucao 15 g, Xuanshen 15 g, Zhe Beimu 15 g, Sheng Muli 30 g (decoct first), Chishao (red peony) 20 g, Huangjing (Polygonatum) 20 g, Zhi Biejia (processed turtle shell) 15 g (decoct first).

Patent medicines:

1. Xihuang Wan, as before.

2. Xiaojin Dan.

Diet therapy and exercise as before. Avoid all tonics and nutritional supplements. Domestic thymosin may continue, one vial every other day.

The patient continued taking the medicine and had several more checks, all showing further tumor shrinkage. But in the most recent month, he grew complacent, taking the medicine on and off and staying up late, and the results clearly declined.

Third visit, November 19, 2016.

At the third visit, the patient reported that he had only taken thymosin for a few days after the first visit and then stopped; entecavir had long been discontinued. A recent physical exam showed platelets slightly low; hepatitis B viral load had been controlled below the minimum detection threshold, diffuse hepatic lesions were well controlled, alpha-fetoprotein was normal, and liver function was normal—reaching a point where antiviral treatment was no longer necessary. He reported chronic lower-back pain due to lumbar spondylopathy and hoped to reduce that pain while treating the cancer. Prescription:

Chaihu 10, Huangqin 10, Chao Baizhu (fried Atractylodes) 20, Fuling 20, Danggui 20, Baishao 20, Huaishanyao 20, Lianqiao 20, Wuweizi 15, Yinchen 20, Chao Zhizi 15, Sheng Gancao 15, Danshen 20, Sheng Huangqi 15, Baihua Sheteng 30, Banzhilian 15, Haifushi 20, Ezhu 15, Sanleng 15, Tengligen 30, Jiangcan 10, Jianghuang 6, Chanyi 6, Xuanshen 15, Zhe Beimu 15, Sheng Muli 30, Kunbu (kelp) 30, Huangjing 20, Kushen (Sophora flavescens) 10, Maidong (Ophiopogon) 10, Tiandong (Asparagus cochinchinensis) 10, Qingpi (green tangerine peel) 10, Wugong (centipede) 3 segments, Qinjiao (Gentiana macrophylla) 10, Duzhong (Eucommia) 10, Xuduan (Dipsacus) 10.

Patent medicines Xihuang Wan, Compound Mylabris Capsules, and Pingxiao Pian to continue.

For over half a year this patient has been taking Chinese medicine and has consistently trusted me. Even though his family all doubted TCM—especially because I was relatively young and did not fit the image of an "old TCM doctor," which made them even more uneasy—the patient nonetheless cooperated fully with treatment. This is an important reason he achieved good results.

Cancer treatment requires mutual trust between doctor and patient, and this patient achieved it. Most patients seeking TCM cancer treatment have only one consultation and then stop, searching everywhere for divine healers, and in the end harm themselves.