Experience Treating a Patient with Breast Cancer and Lung and Bone Metastases Using Modified Maxing Shigan Tang Combined with Wuling San
The patient, a woman surnamed Sun, was 41 years old, a permanent resident of Tianjin working in international trade, with no history of exposure to pollutants or radioactive substances. She had advanced breast cancer with lung and bone metastases. In 2010 she was treated for breast cancer at Tianjin Cancer Hospital (inpatient record no. 269107). By 2020, tumor progression had caused paraplegia; her condition was severe and she was bedridden at home.
In August 2020 the patient first asked me for help. I had no confidence at all in treating such a critically ill patient, so I politely declined. On April 8, 2021, the patient appealed to me again, hoping I could relieve her suffering. I was surprised that, given how severe her condition was, she had managed to survive this long. Unable to refuse her repeated entreaties, I agreed to give it a try.
The patient had two main sources of distress: first, a chronic cough with abundant, thin, clear sputum that congested the upper airway, causing respiratory distress and frequent breath-holding; second, bone-metastatic cancer had caused paraplegia, after which she constantly felt as though all her bones were being squeezed together, with excruciating pain and numbness. She hoped I could improve her quality of life and extend her survival.
Since taking the case, I had tried many phlegm-resolving, cough-suppressing and pain-relieving formulas, all with limited improvement. But the patient never gave up and repeatedly begged me to find another way. Recently I decided to try Maxing Shigan Tang combined with Wuling San, with modifications.
I drafted the following prescription: Zhi Mahuang (Honey-fried Ephedra) 6 g, Xingren (Apricot kernel) 6 g, Sheng Shigao (Raw Gypsum) 18 g (decoct first), Zhi Gancao (Honey-fried Licorice) 6 g, Guizhi (Cinnamon twig) 10 g, Fuling (Poria) 30 g, Zhuling (Polyporus) 10 g, Baizhu (Atractylodes) 10 g, Zexie (Alisma) 10 g, Cheqianzi (Plantago seed) 10 g, Huainiuxi (Achyranthes) 10 g, Buguzhi (Psoralea) 10 g, Gusuibu (Drynaria) 10 g, Duzhong (Eucommia) 6 g, Xuduan (Dipsacus) 6 g, Tusizi (Cuscuta seed) 6 g, Shayuanzi (Astragalus complanatus seed) 6 g, Tinglizi (Descurainia seed) 15 g, Dazao (Jujube) 7 pieces, Shengjiang (Fresh ginger) 7 slices.
This formula uses Maxing Shigan Tang together with Tingli Dazao Xiefei Tang to clear the lung and calm wheezing, and Wuling San, modified with Cheqianzi and Huainiuxi, to promote urination and percolate dampness—clearing the source of phlegm above and expelling fluid retention below. Buguzhi, Gusuibu, Duzhong, Xuduan, Shayuanzi and Tusizi were added to tonify the kidney and strengthen bone. In addition, ChanSu (Toad venom), SheXiang (Moschus), XiongHuang (Realgar), Qiaochong (Eupolyphaga) and ChongLou (Paris polyphylla) were prepared into pills and powder for oral anti-cancer use.
After three doses, the patient’s copious sputum and cough improved markedly and her breathing became much freer. The pain also largely disappeared, though she still felt as though her bones were drawn into a tight mass, with fullness beneath the ribs. I therefore added Meiguihua (Rose bud) 6 g, Xiangfu (Cyperus) 10 g and Bayuezha (Akebia fruit) 10 g to the base formula to broaden the chest and move qi. I also added Huqian Wan (Tiger-Head-Pacing Pill) to address the paralysis and numbness caused by the bone metastases.
This patient had in fact been given up on by every hospital, but because her cancer cells were proliferating slowly, despite the severe symptoms she was not in immediate danger of death—only her quality of life was extremely low. At the time, not only other doctors but even I myself had declined the case because the treatment risk was too high and I worried about doctor-patient conflict. With nowhere else to turn, she repeatedly begged me to help. I did not expect that this simple therapeutic approach could ease some of her suffering. I now write this account for the reference of similar patients and clinicians.