A Case of Enzalutamide Combined with a Large TCM Formula Resolving Prostate Cancer Tumor

Prostate cancer is one of the common malignant tumors of the male urinary and reproductive systems. It arises from the epithelial cells of the prostate and is most common in men over 65.

The patient in this article is an elder of one of my teachers, with whom I am as close as family and in whom we mutually place great trust. So when he was diagnosed with prostate cancer in the second half of 2024, my teacher and his wife directly asked me for a treatment plan.

At the time, the patient was 79 years old. He had presented to our local People's Hospital with difficulty urinating and was found to have prostate cancer. During surgery the cancer was found to have already spread, so surgery was not worthwhile; the tumor was not removed and the incision was simply closed. From then on, his treatment was entirely my responsibility, without any other therapy.

Prostate cancer is a sex-hormone-related cancer that does not progress rapidly. I decided to treat it with enzalutamide, an endocrine drug specifically for advanced prostate cancer, combined with a large TCM formula. It so happened that the family member of a previous prostate cancer patient had given me two leftover boxes of enzalutamide soft capsules, asking me to pass them on to other prostate cancer patients as fate allowed. So I had my teacher's elder take those two boxes of enzalutamide soft capsules, and, following the principle I have long advocated of treating cancer with a large multi-target TCM formula, I prescribed a large herbal regimen. The two approaches were combined for over a year.

In late July 2026, while I was home visiting relatives, I visited this elder at my teacher's home. The clinical symptoms related to prostate cancer had completely disappeared; the most recent ultrasound showed no abnormal lesions in the prostate, and blood tests showed normal basic blood counts, liver function, and renal function.

When I asked in detail about his medication course, my teacher's wife told me that after the two boxes of enzalutamide soft capsules I had passed on were finished, he did not continue Western medicine but kept taking the TCM treatment I prescribed, on and off for over a year. Later, because the symptoms disappeared, the old man had stopped the herbs on his own several months earlier.

In treating this acquaintance, I drew on the approach of the late renowned Shanxi TCM master Men Chunde: I wrote the prescription as four formulas, alternating odd and even days. On odd days he took two groups of herbs; on even days he took the other two groups.

Odd-day medication:

Formula 1: Qingdai (Indigo Naturalis), Banlangen (Isatidis Radix), Daqingye (Isatidis Folium), Sanjieshan (Cephalotaxi Folium), Xishuguo (Camptothecae Fructus), Bihu (Gecko), Wugong (Scolopendra), Quanxie (Scorpio), Changchunhua (Catharanthi Herba), Hongdoushangen (Taxi Cortex/Radix), Sanleng (Sparganii Rhizoma), Ezhu (Curcumae Rhizoma), Chishao (Paeoniae Rubra Radix), Mudanpi (Moutan Cortex), Digupi (Lycii Cortex), Fuling (Poria), Zhuling (Polyporus), Jianghuang (Curcumae Longae Rhizoma), Chao Jiangcan (Stir-fried Bombyx Batryticatus), Chanyi (Cicadae Periostracum), Huangqin (Scutellariae Radix), Xuanshen (Scrophulariae Radix), Zhebeimu (Fritillariae Thunbergii Bulbus), Biejia (Trionycis Carapax), Guiban (Testudinis Plastra), Mohanlian (Ecliptae Herba), Nuzhenzi (Ligustri Lucidi Fructus), Tianhuafen (Trichosanthis Radix), Huaihua (Sophorae Flos), Cebaiye (Platycladi Cacumen), Shishangbai (Selaginellae Doederleinii Herba), Sanqi (Notoginseng Radix), Maweilian (Thalictri Radix), Baitouweng (Pulsatillae Radix), Shandougen (Sophorae Tonkinensis Radix), Sangye (Mori Folium), Kushen (Sophorae Flavescentis Radix), Diyu (Sanguisorbae Radix), Huzhang (Polygoni Cuspidati Rhizoma), Yujin (Curcumae Radix), Lianqiao (Forsythiae Fructus), Jinyinhua (Lonicerae Flos), Jiaogulan (Gynostemmae Pentaphylli Herba), Xiyangshen (Panacis Quinquefolii Radix), Wuweizi (Schisandrae Fructus), Buguzhi (Psoraleae Fructus), Maimendong (Ophiopogonis Radix), Tiandong (Asparagi Radix), Pugongyinggen (Taraxaci Radix), Baishao (Paeoniae Alba Radix), Yuanhu (Corydalis Rhizoma), Tianwuqiao (Corydalis Decumbentis Rhizoma), Honggencao, Xianhecao (Agrimoniae Herba), Xiaoji (Cirsii Herba), Fengweicao (Pteridis Herba), Shijianchuan (Salviae Chinensis Herba).

Formula 2: raw Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), Baishao, Shudi (Rehmanniae Praeparata Radix), Yiyiren (Coicis Semen), Dangshen (Codonopsis Radix), Huangjing (Polygonati Rhizoma).

Even-day medication:

Formula 1: Pugongyinggen, Jinyinhua, Rendongteng (Lonicerae Caulis), Zihuadiding (Violae Herba), Zibeitiankuizi, Yehjuhua (Chrysanthemi Indici Flos), Lianqiao, Zhebeimu, Tianhuafen, Kushen, Xuanshen, Shengmuli (raw Ostreae Concha), Haifushi (Pumex), Daji (Cirsii Japonici Herba), Xiaoji, Banzhilian (Scutellariae Barbatae Herba), Banbianlian (Lobeliae Chinensis Herba), Baihuasheshecao (Hedyotidis Diffusae Herba), Xianhecao, Zicao (Arnebiae Radix), Tianwuqiao, Yuanhu, Shishangbai, Sanleng, Ezhu, Ruxiang (Olibanum), Moyao (Myrrha), Xuejie (Draconis Sanguis), Ercha (Catechu), Danggui, Chuanxiong (Chuanxiong Rhizoma), Chishao 30g, Shengdi, Sanqi, Hongdoushangen, Hongdoushupi (Taxi Cortex), Wugong, Quanxie, Bihu, Hetaopqingpi (Juglandis Catalpae Semen pericarp), Guanzhong (Dryopteridis Rhizoma), Banlangen, Qingdai, Daqingye, Niubangzi (Arctii Fructus), Chonglou (Paridis Rhizoma), Sanyeqing (Sargentodoxae Rhizoma), Xuchangqing (Cynanchi Paniculati Radix), Cu Xiangfu ( vinegar-processed Cyperi Rhizoma), Baiji (Bletillae Rhizoma), Mudanpi, Manjingzi (Viticis Fructus), Chantui, Chao Jiangcan, Pianjianghuang (Wenyujin Curcumae Rhizoma), Sheng Baishao, Duanmuli, Xuanshen, Chuanbeimu (Fritillariae Cirrhosae Bulbus), Zhebeimu, Liangtoujian (Anemones Raddeanae Rhizoma), Lufengfang (Vespae Nidus), Duan Huaruishi, Wubeizi (Galla Chinensis).

Formula 2: Shayuanzi (Astragali Complanati Semen), Tusizi (Cuscutae Semen), Mohanlian, Nuzhenzi, Ciwujia (Acanthopanacis Radix), Bajitian (Morindae Officinalis Radix), Xianlingpi (Epimedii Herba), Shudihuang, Shanzhuyu (Corni Fructus), Zexie (Alismatis Rhizoma), Mudanpi, Rougui (Cinnamomi Cortex), Zhimu (Anemarrhenae Rhizoma), Huangbo (Phellodendri Cortex), Huaishanyao (Dioscoreae Rhizoma).

Both odd and even day formulas were composed following the principles of supporting the righteous and expelling evil, clearing heat and resolving toxin, nourishing yin and downbearing fire, activating blood and resolving stasis, dissipating phlegm and nodules, and using poison to attack poison, with only minor differences in the herbs. The purpose of this regimen is twofold: first, using too many herbs on a single day may overwhelm the body, so they are split to lighten the burden; second, to avoid the early development of drug resistance.

Prostate cancer is not a fast-progressing cancer; moreover, this is an elderly patient whose metabolism is slow and whose cancer therefore progresses more slowly than in younger patients, making treatment less difficult than for more aggressive cancers. These factors may be why this elder of my teacher was able to achieve tumor resolution after taking the medication.