Answers to Some Common Questions About TCM and Cancer

Can cancer be cured? What determines a cancer patient's survival time?

Early cancer can often be cured; in intermediate and late stages, cures are fewer. Treatment of most intermediate- and late-stage cancer patients (especially advanced or end-stage) should aim to prolong life and improve quality of life. Dying patients should no longer undergo traumatic life-extending treatment; hospice care should be the priority.

I have written a dedicated article, Luck, Perseverance, and the Patient-Doctor Bond Jointly Determine a Cancer Patient's Survival Time. Clicking the title link above opens the full text; I recommend patients and families read it for a fuller picture.

What role does TCM play in treating cancer? Is the TCM cure rate high?

TCM treatment of cancer can help patients improve quality of life, raise energy, and prolong survival. A few fortunate patients, under TCM treatment, can achieve long-term survival. The proportion of cancers cured by TCM is not high; for intermediate- and late-stage cancers that have already metastasized, the TCM cure rate is even lower. Usually only a single-digit percentage of patients per hundred achieve long-term survival through TCM; most can only achieve prolonged life and improved quality of life. Much exaggerated advertising is not to be believed.

Which treats cancer better, TCM or Western medicine?

Cancer is a disease requiring multidisciplinary cooperation. TCM and Western medicine each have strengths in treating cancer; neither is superior to the other. When Western medicine is indicated, use Western medicine; when TCM is indicated, use TCM. Integrated Chinese-Western medicine helps patients more.

How a patient chooses is closely tied to the educational and cultural background, economic means, and personal beliefs of the patient and family. According to evidence-based medicine, the treatment plan should ultimately be decided by the patient and family; the doctor should only inform them of the likely efficacy, possible side effects, and estimated cost of each option. It is up to the patient and family to decide. I suggest patients follow the principle "listen to both sides and you will be enlightened; listen to one side and you will be left in the dark" — hear several doctors' advice, then decide carefully.

Generally, early-stage cancer patients should seek surgical resection, since most early cancers can be radically cured by surgery. Intermediate- and late-stage patients, while receiving standard treatment, should consider finding a good TCM doctor for long-term follow-up. TCM can address the side effects of Western treatment and can also resolve some problems Western medicine cannot. Some patients given up on by Western medicine nevertheless survive well and long under TCM treatment. Advanced or end-stage patients for whom surgery, chemoradiation, or other options are no longer available should consider pure TCM treatment. Of course, some patients trust TCM more and are unwilling to undergo Western treatment; their choice must be respected.

Can you recommend some worthwhile popular science books on cancer?

Yes. I particularly like The Emperor of All Maladies: A Biography of Cancer, The Perfect Bet: How Science and Gambling Are Changing the Way We Think About Luck (on cancer's evolutionary story and the path to a cure), and The Biology of Cancer. Among these, The Emperor of All Maladies and The Perfect Bet are accessible and suitable for general readers. The Biology of Cancer is a highly academic tome, suitable for professionals or educated readers wishing to go deep.

In addition, there are specialized popular or academic monographs on different cancer types. For example, the Mayo Clinic organization wrote Breast Cancer: New Directions in the Management of Breast Disease, a professional popular work on breast cancer. Lung Cancer: Principles and Practice (Harey I. Pass, David P. Carbone, et al., recommended reference of the International Association for the Study of Lung Cancer) is a professional popular work on lung cancer. Stomach Cancer, edited by Academician Ji Jiafu, is a professional popular work on gastric cancer. These are all worth reading. I also advise interested cancer patients and families to read popular works to gain a deep understanding of cancer. Fighting cancer is a long process; to fight it, we must know it — "know the enemy and know yourself, and you will fight a hundred battles without defeat."

I want to teach myself TCM anticancer; how should I begin?

First, read TCM Basic Theory, TCM Diagnostics, Chinese Materia Medica, Formulaology, TCM Internal Medicine, TCM External Medicine, the Huangdi Neijing (Yellow Emperor's Inner Canon), Shanghan Lun (Treatise on Cold Damage), Jinkui Yaolue (Essential Prescriptions from the Golden Cabinet), and Wenbing Tiaobian (Systematic Identification of Warm Diseases). At hand you should also keep such dictionaries as the Dictionary of TCM Formulas, the Dictionary of Chinese Materia Medica, and the Zhonghua Bencao (Chinese Herbal) for looking up entries on herbs and formulas. In addition, read monographs on TCM treatment of cancer, such as TCM Treatment of Malignant Tumors, TCM Oncology, and the TCM Diagnosis and Treatment Guidelines for Malignant Tumors. Also read monographs and case records written by anticancer doctors. I believe that as you read the above works, you will, through their references, track down further works for advanced study.

What should cancer patients pay attention to in diet?

I have written a dedicated article on this for cancer patients; you may read it by clicking the link below: My Personally Recommended Diet and Nutritional Supplement Plan for Cancer Prevention and Anticancer.

Should all cancer patients give up sex?

Except for patients whose doctor has specifically told them not to, all cancer patients may be sexually active.

Does exercise help cancer patients recover?

Yes. All exercise is beneficial for cancer patients; for some specific cancers, choosing the corresponding exercise is even more beneficial — for example, swimming is very beneficial for prostate cancer patients. The great majority of cancer patients in rehabilitation should increase exercise, maintaining 150 minutes or more of aerobic exercise per week (enough to break a sweat). Obese cancer patients should also increase exercise intensity to control weight. The WHO standard weight calculation is:

Men: (height in cm − 80) × 70% = standard weight

Women: (height in cm − 70) × 60% = standard weight

Within ±10% of standard weight is normal; ±10%–20% is overweight or underweight; beyond ±20% is obese or underweight. I suggest people weigh themselves often to maintain a healthy figure.

What are the common carcinogens?

There are simply too many carcinogens to enumerate. You can Baidu-search the WHO list of carcinogens and find hundreds. Pickled foods, grilled and fried foods, tobacco, and alcohol that we commonly eat are all on it. Generally, as long as you stop smoking and limit alcohol, and eat fresh rather than pickled, fried, grilled, or smoked foods, you are quite safe.

Are cancer patients' children more likely to get cancer than others?

Yes. The reasons cancer patients' children are more likely to get cancer are multiple. Some cancers are familial genetic diseases, such as breast cancer caused by BRCA mutations. Some arise because, within the same household, it is easier to transmit certain viruses or bacteria that promote cancer — hepatitis B virus and H. pylori, for example, spread easily among family members; hepatitis B and H. pylori infection are premalignant lesions of liver and gastric cancer respectively. Some arise because the same family readily develops the same bad habits, such as a taste for pickled foods or betel nut.

Can cancer be prevented?

Over a third of cancers are preventable, because they are closely tied to lifestyle. The simplest cancer prevention is: stop smoking, limit alcohol, do not stay up late, exercise often, eat a balanced diet, eat less junk food, and maintain emotional balance. If a checkup finds premalignant lesions (such as H. pylori, atrophic gastritis, gastric ulcer, gallstones, reflux esophagitis, HPV positivity, etc.), you should be even more diligent about prevention.

Are Chinese herbs toxic? Do they damage important organs like the liver and kidneys?

Every medicine has some toxicity; Chinese herbs are not only toxic, some are quite toxic.

Especially in herbs used for cancer and similar diseases, many are "using toxin to attack toxin" toxic herbs, which will cause some damage to the patient's body.

Some herbs can damage the liver, kidneys, and other important organs; while taking them, patients should frequently check liver and kidney function. If abnormalities appear, consult the prescribing doctor, to avoid progression to drug-induced liver necrosis or renal failure.

Sometimes treating major malignant disease requires accepting some cost in liver and kidney damage; the doctor should inform the patient in advance. But such damage should be kept within a controllable range and not allowed to progress out of control; after the treatment goal is reached, efforts should be made to restore liver and kidney function.

I myself often advise patients to have liver and kidney function checked regularly, to avoid serious consequences such as renal failure and liver necrosis.

Clinicians should not shy away from this point; only by treating patients honestly and responsibly can patient safety be assured, and the doctor's own professional safety as well.

I have seen many serious consequences of taking Chinese herbs in my clinical work. So I often warn patients not to take medicine year after year without end; medicine treats illness, it is not food to be taken daily.

Even treating major diseases like cancer, one should not take medicine 365 days a year without a break. The body's organs need time to rest; a doctor treating a patient should not turn them into a medicine pot.

On decocting herbs

It is best to use an earthenware pot to decoct herbs; earthenware is chemically stable and unlikely to react with the herbs, making it the ideal vessel. Ceramic pots are second best. Avoid metal pots as much as possible.

Some mineral or shell fossils in prescriptions are hard to decoct, so the doctor often notes "decoct first" (xianjian) — for instance Biejia (Carapax Trionycis), Sheng Muli (raw Ostreae Concha), Walengzi (Cypraeae Concha), Haifushi (Pumex), Daizheshi (Haematitum). Such first-decocted herbs are generally boiled first for about half an hour.

Some highly toxic herbs must be decocted first to remove their toxicity — such as Fuzi (Aconiti Lateralis Radix preparata). The length of pre-decoction depends on the dose prescribed; unless otherwise specified, Fuzi should be pre-decocted for at least 30 minutes; over 50 g requires one hour; over 100 g requires two hours.

Some herbs lose active constituents with prolonged boiling — such as raw Dahuang and Jineijin (Galli Stomachichum). The prescription usually notes "add late" (houxia); these are put in after the other herbs are done and boiled for another five to ten minutes.

Herbs like Renshen (ginseng) may be decocted separately and then mixed into the strained liquid, to avoid wasting costly herbs.

Some herbs, such as Mangxiao (Mirabilitum), need not be decocted at all; simply pour them into the warm decoction to dissolve. Also, costly glue-type herbs such as Ejiao (Asini Corii Colla) and Lujiaojiao (Cervi Cornus Colla) were in the past melted (yanghua) into the decoction; today they are often ground to powder and taken infused — these points deserve attention.

Before decocting, soak the herbs for about 15 minutes, adding water to about 1–2 cm above the herb surface.

On taking the medicine

Unless the doctor specifically instructs taking on an empty stomach in the early morning or before bed, Chinese medicine is generally taken about one hour after meals. Do not take it immediately after eating, lest food and medicine mix and be poorly digested and absorbed.

Some herbs should be taken on an empty stomach for better effect; the doctor will specifically instruct, and in such cases follow medical advice.

Each dose is 100–200 ml; the decoction may be made fairly concentrated so as not to drink too much and spoil the appetite.

Patients should suspend Chinese medicine during a cold; ask the doctor to treat the cold separately, and resume the herbs after the cold resolves. Female patients should stop Chinese medicine during menstruation.

Dietary prohibitions

While taking Chinese medicine, avoid all spicy, sour and spoiled, raw and cold, overly greasy, grilled, and cheese-like foods. The diet should center on cooked, soft, easily digested foods, with variety. Seasonal fruits and vegetables that easily cause gastrointestinal discomfort should all be avoided. Bean foods and other gas-producing foods should also be avoided.

In addition, while taking Chinese medicine, it is best to avoid foods opposite in nature to the herbs. For example, when taking heat-clearing, toxin-resolving herbs, avoid warm-hot foods such as beef, lamb, and chili. When taking warming-tonifying herbs, avoid cold-bitter foods such as bitter melon. When taking astringent herbs, avoid foods with diuretic or purgative effects, such as winter melon.

These should all be discussed with the doctor when the prescription is written; attending to diet while taking the medicine better ensures the therapeutic effect.