Experience Treating a Child with Stage 4 High-Risk Neuroblastoma Using Pure Traditional Chinese Medicine

Stage 4 high-risk neuroblastoma is extremely difficult to treat. At present, when Western methods combining surgery with radiotherapy and chemotherapy are used to treat children with stage 4 high-risk neuroblastoma, the success rate is close to zero, so many doctors give up on such children.

In recent years I have treated several hundred children with stage 4 high-risk neuroblastoma, but few were willing to rely on pure traditional Chinese medicine (TCM). Apart from the first few neuroblastoma children I took in, who came to me for pure TCM after Western treatment had failed, virtually none of the newly arriving neuroblastoma children were treated with pure TCM. Almost all were treated mainly by Western medicine, with only occasional doses of Chinese medicine; such treatment seldom produces good results.

The neuroblastoma child introduced in this article has been treated by me with pure TCM for the past half year or more.

This is a girl surnamed Jiang from Shaoxing, Zhejiang Province. She was born in May 2010 and was diagnosed with neuroblastoma three and a half years earlier. Her disease was retroperitoneal ganglioneuroblastoma (nodular type, with poorly differentiated neuroblastoma components inside the nodules), and diffuse lymphatic and bone metastases had already appeared; recently there was also suspected orbital metastasis. Previously she had undergone surgical removal of the adrenal gland and accessory spleen, and had received 21 courses of chemotherapy, but no radiotherapy.

The child's mother contacted me on January 24, 2019, referred by the family of another neuroblastoma patient, hoping for my help. By then I had already accumulated some experience treating other neuroblastoma children, so I prescribed the medication regimen that had proved effective for several other children. After taking it, the child's neuron-specific enolase (NSE) marker dropped markedly, and her mother was very satisfied with the effect.

Thereafter I kept refining and modifying the regimen, but on the May 31 follow-up the child's NSE had risen slightly. I therefore added norcantharidin tablets and toxin-attacking medicines such as scorpion (Quanxie) and centipede (Wugong) to bring the NSE back down.

On July 11, after the child's summer vacation began, she came to my clinic for her first in-person consultation. On examination, both left and right pulses were fine, wiry, rapid, and forceless; her appetite was fair; her stools were formed, bulky but not dry; her feet sometimes had cramping pain. Her NSE had been rising recently, and there were signs of a relapse that could not be brought under control.

I therefore further intensified the medication on the basis of the previous regimen and introduced the relatively expensive Xihuang Wan (Xihuang Pill).

On July 27 the child began to walk with an abnormal gait, so her mother took her to hospital for examination. Her NSE had soared to 136.7 and her C-reactive protein was 27.36. She developed a fever and slightly dry stools. Her mother also noticed that, starting July 20, the child's secondary sexual characteristics had begun to develop.

Fever and pain are precisely the typical signs of relapse in most neuroblastoma children. Given her condition, I asked her mother to prepare a decoction for her. I prescribed Chai Ge Jie Ji Tang combined with Sheng Jiang San: Chaihu (Bupleuri Radix) 12 g, Gegen (Puerariae Radix) 9 g, Gancao Radix 3 g, Huangqin (Scutellariae Radix) 9 g, Qianghuo (Notopterygii Rhizoma) 6 g, Baizhi (Angelicae Dahuricae Radix) 6 g, Baishao (Paeoniae Alba Radix) 6 g, Jiegeng (Platycodi Radix) 6 g, raw Shigao (Gypsum Fibrosum) 12 g (decocted first), Pian Jianghuang (Curcumae Longae Rhizoma) 6 g, stir-fried Jiangcan (Bombyx Batryticatus) 10 g, Chanyi (Cicadae Periostracum) 6 g, cooked Dahuang (Rhei Radix) 3 g.

On July 29, after three days of medication, the fever subsided and the pain stopped. One week later, a follow-up test showed the NSE had fallen to 102. However, the child refused to continue taking the decoction, which is a common problem in pediatric patients—children can rarely persist with herbal decoctions.

On August 8 the child developed fever again, and a movable lymph node could be felt above the scapula. Her mother had the same decoction I had prescribed previously prepared for her again.

On August 24 the mother reported that the child had been aching all over for days and had lost several jin in weight; she did not dare stop either the decoction or the patent medicines, because stopping any of them brought back the fever and pain.

Starting August 28 the child developed fever again, with migrating pain over the body, fatigue, listlessness, rapid weight loss, and cold sweat on the palms and soles. After more than three years of chemotherapy she had endured enormous suffering and strongly resisted further chemotherapy. Her parents turned to me again, hoping I could find a way to help.

I prescribed the original Qinghao Biejia Tang (Sweet Wormwood and Turtle Shell Decoction): Shengdi (Rehmanniae Radix) 12 g, Biejia (Trionycis Carapax) 12 g, Mudanpi (Moutan Cortex) 6 g, Zhimu (Anemarrhenae Rhizoma) 6 g, and asked the parents to have her take it for a while.

On September 8 the parents reported that the child no longer had cold sweat and her appetite had recovered slightly, but the fever had still not subsided, reaching as high as 39.4 degrees. The parents asked me to guide the next step of medication.

I then tried a modified Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction): Chaihu 16 g, Huangqin 10 g, Fabanxia (Pinelliae Rhizoma) 10 g, Shengjiang (Zingiberis Rhizoma Recens) 10 g, Dangshen (Codonopsis Radix) 8 g, Zhi Gancao (honey-fried Glycyrrhizae Radix) 8 g, Guizhi (Cinnamomi Ramulus) 12 g, Baishao 12 g, Dazao (Jujubae Fructus) 5 pieces, Pian Jianghuang 12 g. I instructed them to give two doses a day, taking it every two hours—four times a day—and to observe for three days.

On September 10 the parents reported that on the afternoon of September 9 the child's temperature had fallen to 38.1 degrees, and on the afternoon of the 10th to 37.9 degrees, with no fever on either of the two mornings. However, over these three days the child had not taken two doses a day as I requested but had halved the amount. Still, her spirit and appetite had clearly improved, though she became irritable. I instructed them to add 30 g of raw Shigao to the previous prescription and continue.

After repeated treatments that did not work as quickly as hoped, the child began to give up on herself, refusing to keep taking medicine and refusing to go to the hospital. On September 15 her temperature rose again to 39.1 degrees, on September 16 to 39.4, and on September 17 to 39.7. Each night the fever would subside on its own after 11 p.m. and rise again around 3 a.m.

As the child's fever persisted and grew hotter, redness and swelling suggestive of metastasis appeared around her eye socket (a common site of metastasis in neuroblastoma patients), the cancer pain intensified, and her legs ached badly with each fever. Her will to go on gradually faded; she wanted only to die and constantly refused to take medicine. But her mother could not bear it and wanted to continue, asking me to prescribe again to bring down the fever and ease her suffering.

I therefore applied a fever-reducing approach I had learned from an older physician, using a modified San Ren Tang combined with Sheng Jiang San.

Prescription: Huoxiang (Agastachis Herba) 3 g, Baidoukou (Amomi Fructus Rotundus) 3 g, Yinchen (Artemisiae Scopariae Herba) 30 g, Huashi (Talcum) 30 g (wrapped), Chuanmutong (Clematidis Armandii Caulis) 6 g, Huangqin 10 g, Lianqiao (Forsythiae Fructus) 10 g, Zhejiang Beimu (Fritillariae Thunbergii Bulbus) 10 g, Pian Jianghuang 12 g, Bai Jiangcan 10 g, Chanyi 10 g, Dahuang 6 g, raw Yiyiren (Coicis Semen) 30 g, Tufuling (Smilacis Glabrae Rhizoma) 30 g, Yuxingcao (Houttuyniae Herba) 30 g, Cangzhu (Atractylodis Rhizoma) 12 g, Baizhu (Atractylodis Macrocephalae Rhizoma) 12 g, Shichangpu (Acori Tatarinowii Rhizoma) 6 g, Bohe (Menthae Haplocalycis Herba) 6 g, Tongcao (Tetrapanacis Medulla) 6 g.

Two doses a day, each dose divided into two portions, taken every two hours, regardless of meals. Once the fever subsides, reduce to one dose a day, divided into three portions, taken after meals.

To address the child's repeated, spontaneous stopping of medication, this time I pressed the family a little, asking them to take the medicine patiently for about a month without repeatedly stopping or changing the prescription.

On October 1 the child's mother told me that after persisting with the medicine, the fever had subsided, the suspected metastatic redness and swelling around the eye socket had resolved, and appetite and stools had returned to normal. She asked me to guide further medication. I told her that since the regimen was working, the prescription should not be changed and should be continued.

Treating child cancer patients is extremely arduous, mainly because children's emotions are unstable and they find it hard to persist with medication, especially decoctions. Many children cannot even keep taking patent medicines, so treatment so often fails at the last moment.

Judging from this child's course, TCM treatment of neuroblastoma—provided the formula matches the pattern—does not act slowly; at the very least it can ease the child's suffering, eliminate some metastatic lesions, and prolong life (which is all that current Western chemotherapy achieves as well). But the treatment is also very demanding.

This child, having endured 21 courses of chemotherapy, firmly refused further Western treatment, and her mother trusted me enough to keep relying on Chinese medicine to solve her problem despite repeated interruptions, when there was no other option.

I do not know whether this child has achieved only temporary remission or will go on to create a miracle and survive; of course I hope it is the latter. But even if a miracle of survival occurs, the treatment ahead will still be a hard struggle against fate, requiring sufficient patience and perseverance from both doctor and patient.

Treating cancer is no easy task. Over the years I have treated many cancer patients, and every successfully treated patient only looks back on the treatment course with a sense of ease; during the treatment itself it is always like trudging through a marsh. In the end, only the strong-willed patients and their families find joy in the process; most fragile patients and families fall by the wayside.