Four Cases: Professor Wu Yichun Treating Cancer with Pingxiao Pian Alongside Decoctions

Professor Wu Yichun (1918-1997) was a native of Xingping County, Shaanxi. As a boy he studied literature and history at a mission school; in 1942 he entered the National Defense Medical College and after graduation worked at the Beibei Hospital in Chongqing. He returned to Shaanxi in 1941 to teach at the Fourth Military Medical University, and in 1956 studied TCM at the Wuhan TCM Research Class, returning afterward to the Fourth Military Medical University to teach and practice. Professor Wu was an executive director of the PLA TCM Association. He long devoted himself to TCM clinical work and tumor prevention and treatment, establishing a lung-cancer diagnostic-therapeutic system centered on the "qi-moving turbidity-expelling method" and proposing the "interbinding of qi stagnation, phlegm, and stasis" mechanism of cancer. Together with Professor Jia Kun and others, he clinically developed Pingxiao Pian for malignant tumors.

Pingxiao Pian is an anti-cancer Chinese patent medicine. Its composition is Xianhecao (Agrimoniae Herba), Zhiqiao (Aurantii Fructus), Yujin (Curcumae Radix), Ganqi (dry lacquer), Wulingzhi (Trogopterori Faeces), Mingfan (alum), and processed Maqianzi (Strychni Semen). Originally called "Pingxiao Dan," it was used clinically in some medical institutions in Xi'an, Shaanxi. Because it showed some effect against various tumors, it was promoted and finally approved for market, becoming a common anti-cancer patent medicine.

Today Pingxiao Pian or Pingxiao Jiaonang is produced by several pharmaceutical companies including Xi'an Zhengda Pharmaceutical and Liaoning Shengshi Pharmaceutical. It is listed in the Class A medical-insurance drug formulary, so patients can obtain it at their designated medical-insurance institutions. Compared with famous anti-cancer medicines such as Xihuang Wan, Pingxiao Pian is inexpensive; after insurance reimbursement the burden on patients is light, and most can afford long-term use.

Among Professor Wu Yichun's own published tumor cases are several treated mainly with Pingxiao Pian; four are reproduced below.

Case 1: Giant-cell tumor patient Mr. Su

Su, male, 59, first visit March 17, 1963. This patient had had severe pain from a mass in the right lower leg for six years, with chest pain recurrent in the last two years. In 1957 an egg-sized hard, extremely painful mass appeared on the outer right calf and was diagnosed at a Changchun hospital as "giant-cell tumor of the distal right tibia." In June 1958 he underwent amputation in Shenyang; in 1961 a mass shadow was found in the right lung with severe chest pain, and cancer cells were found in sputum, diagnosed by Western medicine as "pulmonary metastasis." He sought treatment at major hospitals in Beijing, Shanghai, and elsewhere, but none offered effective therapy; finally he decided to try Chinese medicine and came to Professor Wu. At the visit he looked fatigued and in pain; the pulse was deep and wiry, the tongue dark with a white greasy coating.

Professor Wu differentiated the pattern as kidney deficiency with blood stasis and phlegm binding, and planned treatment with Pingxiao Pian combined with a decoction. Pingxiao Pian, 8 tablets three times daily, three months as one course.

Decoction prescription: Buguzhi (Psoraleae Fructus) 30 g, Heshouwu (Polygoni Multiflori Radix) 30 g, Walengzi (Arcae Concha) 30 g, Lujiaoshuang (deer antler cream) 30 g, Yujin 30 g, Tubimu (Bolbostemmatis Rhizoma) 30 g, Lufengfang (Vespae Nidus) 30 g, Wugong (Scolopendra) 2 pieces, Moyao (Myrrha) 10 g, Shancigu (Cremastrae/Appendiculata Pseudobulbus) 15 g, Ezhu (Curcumae Rhizoma) 10 g, Gancao 3 g.

After the second visit, chest pain disappeared, sputum decreased, and the lung shadow shrank markedly. Professor Wu told him to stop the decoction and continue Pingxiao Pian. For the next five years he was stable and stopped the medicine on his own. Half a year later, on February 6, 1969, he again felt severe chest pain, copious sputum, shortness of breath and fatigue, and general discomfort; chest X-ray showed "the right hilum shadow enlarged to fist size, with dense opacity." He returned to Professor Wu, who had him resume the original regimen—decoction plus Pingxiao Pian, using the initial prescription.

After three months symptoms eased, and X-ray showed "marked absorption and shrinkage of the right hilar mass"; feeling well, he was told to resume work and continue Pingxiao Pian. On follow-up March 5, 1972, X-ray showed "the original tumor shadow basically dissipated." Follow-up through February 27, 1992, with chest X-ray, routine blood, urine, and stool tests, and liver and kidney function, showed no abnormalities. By then the patient had taken Pingxiao Pian for 20 years.

Commentary: Recurrence of a giant-cell tumor after surgery, treated with pure Chinese medicine, with disappearance of the metastatic tumor and 20 years of survival—quite an achievement. But the patient's perseverance is also admirable; continuing medication for 20 years to control a tumor is beyond most people. For patients needing long-term medication, a patent medicine like Pingxiao Pian is far better than a decoction; most patients cannot tolerate or stick to long decoction courses, and long-term decoctions also carry heavy side effects that may harm the stomach, liver, and kidneys.

The Maqianzi (nux vomica) in Pingxiao Pian is actually a highly toxic herb; overdose or improper use can cause fatal side effects. But trace amounts of processed Maqianzi can fight cancer. Maqianzi is very effective for orthopedic diseases; TCM has long said "without Maqianzi there is no good orthopedics." This patient's tumor was a giant-cell tumor, so Pingxiao Pian was well matched.

In addition, Professor Wu's decoction was itself praiseworthy. Buguzhi, Heshouwu, and Lujiaoshuang all supplement the kidney and strengthen bone; Walengzi, Tubimu, and Shancigu soften and dissipate hard masses and fight cancer; Yujin, Ezhu, and Moyao activate blood and resolve stasis; Lufengfang and Wugong use poison to attack poison; and Gancao harmonizes all the herbs at a very light dose. The decoction itself also treated the giant-cell tumor.

Case 2: Bronchial pigment-cell carcinoma patient Mr. Wang

Wang, male, first visit May 29, 1964.

From early December 1963, for no clear reason, the patient developed chest pain, paroxysmal cough, blood-streaked sputum, chest tightness, and shortness of breath. Chest X-ray and sputum cytology confirmed "right bronchial pigment-cell carcinoma." After taking nitrogen mustard 20 mg and radiotherapy, he developed severe radiation pneumonitis and could not continue Western treatment, so he turned to TCM. At the visit his face was purplish-dark, the tongue crimson-purple, breathing rapid, and the pulse fine, rapid, and slightly slippery.

Professor Wu differentiated the pattern as qi stagnation, blood stasis, and phlegm obstruction in the lung channel, and planned treatment to diffuse the lung and move qi, resolve stasis and phlegm, while treating the disease itself with Pingxiao Pian's anti-cancer action.

Initial prescription: Sheng Aiye (raw Artemisiae Argyi Folium) 20 g, garlic 20 cloves, Baibu (Stemonae Radix) 12 g, Chenpi 10 g, Mugu (Chaenomelis Fructus) 12 g, Zhechong (Eupolyphaga) 10 g, Walengzi 30 g, Shandougen 10 g, Lufengfang 10 g, Shengjiang 10 g, Sanqi 5 g, Gancao 3 g. At the same time take Pingxiao Pian, 8 tablets three times daily.

The patient followed the advice for over a year. On return February 12, 1965, symptoms had basically disappeared and spirits had improved; chest X-ray showed "increased density in the upper right lung with pleural thickening." He then returned to work, stopped the decoction, but persisted in taking Pingxiao Pian to prevent metastasis and recurrence until he died suddenly of a myocardial infarction at home on February 16, 1992. He survived 29 years on the medicine.

Commentary: This patient developed radiation pneumonitis after radiotherapy and could not continue Western treatment. Professor Wu's decoction contained both herbs for radiation pneumonitis—Sheng Aiye, garlic, Baibu, Chenpi, Shengjiang, and Mugu—and anti-cancer, swelling-reducing herbs such as Zhechong, Walengzi, Shandougen, Lufengfang, and Sanqi. The interesting herb here is garlic; garlic not only kills bacteria and stops cough but also has some anti-cancer effect, though few TCM physicians directly use it as an herb. Professor Wu's use of garlic is an unconventional touch.

Case 3: Glioma patient Ms. Zhou

Zhou, female, 23, first visit January 15, 1965.

From March 1964 the patient developed severe headache, nausea, vomiting, and diplopia. Fundoscopy showed papilledema; she underwent decompression surgery in neurosurgery, and histopathology of the section confirmed "right cerebral glioma" with glial nodule formation and neuronal degeneration. She had no surgical indication and could not be operated on, so she chose radiotherapy for symptom relief and then Chinese anti-cancer medicine. At the visit she was restless; the tongue was red with a yellow greasy coating and the pulse wiry and rapid.

Professor Wu differentiated the pattern as liver-gallbladder damp-heat with blood stasis and phlegm binding. Combining pattern and disease treatment, he planned to clear liver-gallbladder and drain damp-heat, resolve stasis and phlegm, combined with Pingxiao Pian.

Decoction: Longdancao (Gentianae Radix) 15 g, Shanzhizi (Gardeniae Fructus) 10 g, Chaihu (Bupleuri Radix) 10 g, Shengdihuang 15 g, Cheqianzi 15 g, Zexie (Alismatis Rhizoma) 10 g, Yuanhu (Corydalis Rhizoma) 15 g, Zhechong 10 g, Jiangchan (Bombyx Batryticatus) 15 g, Xuanfuhua 10 g (wrapped), Daizheshi 30 g (wrapped), Shijueming (Haliotidis Concha) 30 g (decocted first), Baihuasheshecao 30 g. At the same time take Pingxiao Pian, 8 tablets three times daily.

The patient persisted for over a year. At the second visit on February 3, 1966, symptoms were basically gone; she only occasionally felt dizzy, everything else was normal, and she had returned to work. Professor Wu told her to stop the decoction and keep taking Pingxiao Pian. She continued it thereafter; follow-up to March 17, 1991 found she had taken Pingxiao Pian for 27 years with no adverse effects and was still taking it.

Commentary: Glioma patients, besides tumor compression of cranial nerves, usually also have cerebral edema and the like, causing nausea, vomiting, headache, and diplopia—belonging to the shaoyang pattern in TCM. Professor Wu's decoction was a Chaihu-Tang-series formula for shaoyang syndrome: Chaihu, Zhizi, and Longdancao clear heat and drain the gallbladder to descend counterflow and stop vomiting; Cheqianzi and Zexie promote urination and reduce swelling to ease cerebral edema; Xuanfuhua and Daizheshi, from Xuanfudaizheshi Tang, stop vomiting; Yuanhu and Shijueming treat headache. These rapidly relieved clinical symptoms and suffering. Alongside symptomatic supportive care, Pingxiao Pian fought cancer and reduced swelling. Treating both branch and root helps build the patient's confidence and improves adherence.

Case 4: Undifferentiated carcinoma of the right upper lung patient Mr. Feng

Feng, male, 34, first visit March 28, 1964.

From early January 1964 the patient developed cough, hemoptysis, and severe right shoulder pain. Chest X-ray and transthoracic needle biopsy confirmed "undifferentiated carcinoma of the right upper lung." He had distended neck veins, severe back pain, and upper-limb numbness, so no surgery was performed. At the visit he was emaciated and fatigued; the tongue was pale with a white greasy coating and the pulse fine and weak.

Professor Wu differentiated the pattern as lung-qi deficiency with phlegm congealing and blood stasis. Combining pattern and disease treatment, he planned a decoction plus Pingxiao Pian.

Decoction prescription: Sheng Huangqi 30 g, Taizishen 30 g, Fuling 12 g, Banxia 10 g, Banzhilian 15 g, Banbianlian (Lobeliae Chinensis Herba) 15 g, Chenpi 10 g, Quanxie 5 g, Danshen 25 g, Yujin 15 g, Shanlangen (Isatidis Radix) 15 g, Lufengfang 10 g, Walengzi 30 g, Gancao 3 g, Yuanhu 15 g.

The patient kept taking the medicine until the return visit on December 3, 1964. Symptoms gradually eased, spirits and strength recovered, and he had returned to work. After the second visit he was told to stop the decoction and use Pingxiao Pian long-term to prevent recurrence and metastasis. He then saw Professor Wu once a year for 19 years straight, persistently taking Pingxiao Pian. In 1984 he changed jobs and contact was lost; follow-up had by then reached 20 years.

Commentary: Young patients with undifferentiated lung cancer have fast metabolism, highly malignant cancer cells, and rapid tumor progression. This patient did not have systemic staging, but judging from his symptoms he may already have had bone metastasis. Professor Wu's decoction targeted the presenting symptoms: because he hemoptysed, Shanlangen (likely Banlangen, Isatidis Radix), Lufengfang, and Walengzi stopped bleeding; Sheng Huangqi and Taizishen supported the root; Chenpi, Fuling, and Banxia resolved phlegm and stopped cough; Banzhilian and Banbianlian cleared heat, resolved toxin, and fought cancer; Quanxie used poison to attack poison; Danshen and Yujin resolved stasis and fought cancer. Long-term Pingxiao Pian then fought cancer and reduced swelling. Treating both branch and root relieved his condition.

These four cases of Professor Wu Yichun are all valuable references. In treating cancer patients, he (1) combined pattern differentiation with disease-specific treatment, prescribing a tailored decoction for clinical symptoms while uniformly using Pingxiao Pian for the cancer itself; and (2) once symptoms eased, stopped the decoction and had the patient keep taking Pingxiao Pian long-term to fight cancer and prevent recurrence.

If a drug's effect on a disease is not reproducible, its research value is limited; truly effective drugs show a degree of reproducibility, even if the effective rate is not 100%. Professor Wu's four cases used the same disease-specific drug with reproducible results, so the drug has real value. The national drug regulator's eventual approval of Pingxiao Pian for sale required exactly such clinical data.

Professor Wu rarely changed formulas frequently. His decoctions were mostly temporary, stopped once symptoms eased. But he never let patients stop Pingxiao Pian; all four patients in his cases took it for over 20 years. Cancer is a chronic disease prone to recurrence, so "once you have cancer, fight it for life"; an effective regimen should be adhered to lifelong.

But to be factual, Pingxiao Pian's effective rate against cancer is quite limited. I have used it for years, and truly effective patients are fewer than 10%, let alone cures. Developing disease-specific anti-cancer formulas and raising the effective rate of TCM oncology remains a task for all of us in the TCM community.