The Growth Rate of Liposarcoma Holds Promise for Being Altered

Liposarcoma is not the same as the lipoma we usually speak of. A lipoma is a benign proliferative tissue, but liposarcoma is malignant. Liposarcoma is a common soft-tissue tumor in adults, though it can also occur in adolescents and children. Liposarcomas are usually large, generally deep-seated, painless tumors that gradually grow. Liposarcoma patients are usually in very good physical condition, their normal lives are unaffected, and they do not look like patients; they die only in the final stage from various problems caused by the uncontrollable tumor.

According to histopathological classification standards, liposarcoma can be divided into atypical lipomatous tumor / well-differentiated liposarcoma, dedifferentiated liposarcoma, myxoid liposarcoma, pleomorphic liposarcoma, and mixed-type liposarcoma. The prognosis of liposarcoma is mainly related to the location of the tumor; the deeper the location, the worse the prognosis. Liposarcoma is most often seen in the lower extremities, retroperitoneum, perirenal area, mesenteric region, and shoulder. If the patient's sarcoma is in a relatively superficial location and can be completely resected, there is hope for a radical cure; deep-seated liposarcomas that cannot be completely resected usually recur very quickly.

Liposarcoma is a tumor that recurs extremely easily. If surgery cannot remove it cleanly, the patient's tumor will rebound very quickly. I have seen a liposarcoma patient from Jiangsu whose tumor, two weeks after his seventh surgery, had rapidly grown larger than it had been before the operation; I have also seen a liposarcoma patient from Hunan whose tumor recurred to nearly 10 cm about a month after his second surgery.

In April 2018, a liposarcoma patient from Shanxi sought my treatment for his tumor. Before coming to me, he had already undergone surgical resection, but unfortunately it recurred. After recurrence, the tumor grew at a rate of about 3 cm per month; after receiving TCM treatment, the tumor was still growing, but the growth rate had slowed to 1 cm every 3 months.

After seeing the patient's tumor growth rate slow down, his previous surgeon advised the patient to patiently take herbal medicine and wait until the tumor grew so large that surgery was unavoidable before operating, because, in his judgment, this patient's tumor could not be eradicated and would recur again shortly after another surgery. This surgeon is a very famous surgeon in China, highly renowned among liposarcoma patients, but over the years he has also seen numerous cases of patients rapidly recurring after multiple surgeries. So when he saw the patient's tumor growth rate slow, he felt this therapeutic effect should be cherished and the frequency of surgery minimized.

Later, for a period, under herbal treatment the patient's tumor shrank. At the time both the patient's family and I were very excited; later, due to drug resistance, the tumor slowly grew again. After this patient's tumor growth rate slowed, his surgery was postponed for more than two years. For liposarcoma patients, postponing surgery by more than two years is quite something; I have seen many liposarcoma patients who have undergone several surgeries within two years. Because liposarcoma is characterized by rapid recurrence, and the later it gets, the shorter the interval between two surgeries; some patients face a new operation just one or two months after surgery.

Current treatment of liposarcoma is mainly surgical, but patients whose tumor is in a poor location often recur after surgery. Some liposarcoma patients in China have undergone more than ten surgeries and still recur frequently. Chemotherapy is not effective for this disease. A liposarcoma patient from Zhejiang whom I know had some effect after using the PD-1 plus anlotinib regimen, but this regimen is expensive, and clinical data is still lacking on how high the response rate is, to what degree patients can achieve remission, and for how long it can be controlled.

Successful TCM case reports on liposarcoma are also rare. In Professor He Ren's work, Selected Case Analyses of He Ren's Treatments of Difficult and Severe Diseases, there is a recorded case of a liposarcoma patient treated by Professor He. Professor He treated the patient mainly by nourishing yin and supplementing the kidney, and clearing heat and resolving toxin, achieving the effect of shrinking the tumor. However, the follow-up period for this case was short, only about half a year, and it is unknown what happened to the patient thereafter.

I have followed up several effective liposarcoma patients I treated for a relatively long time, all over two years; after their tumors shrank in stages, most rebounded later on. I am also continuing to explore better treatment options for liposarcoma.

The poor effect of internal Chinese and Western medications on liposarcoma may be related to the fact that this tumor, unlike other cancers, does not have a rich vascular network. Liposarcoma lacks abundant vascular tissue, so conventional Western chemotherapy regimens that inhibit angiogenesis do not work well on it, and the TCM method of activating blood and resolving stasis is also not very effective for liposarcoma. I have tried treating liposarcoma according to dampness-draining and fat-dissolving protocols, with poor results too. I once saw a liposarcoma patient who achieved some effect under another TCM physician using external application plus internal herbal medicine, but later recurred as well.

One liposarcoma patient from Hunan whom I treated also only achieved slowing of the tumor's growth rate, without eliminating the tumor. I treated this patient for two years; at first the tumor still grew, just more slowly, but in the most recent five months the tumor has basically stopped growing, though the existing tumor has not shrunk—merely maintaining a state of survival with the tumor.

A liposarcoma patient from Shandong whom I treated for over two years after surgery has remained well at every follow-up to date, with no sign of recurrence. But would this patient also not have recurred without taking herbal medicine? That is hard to judge. Because when this patient came to me, there was no tumor left in the body, so this case is hard to use as evidence that TCM treatment is effective for liposarcoma. I will continue to follow up this patient.

In my experience, by following TCM principles and altering the patient's constitution, combined with appropriately taking some herbal medicines that promote the apoptosis of tumor cells, it is possible to slow the recurrence and growth rate of liposarcoma. I have treated quite a number of liposarcoma patients—enough to carry out a specialized study on TCM treatment of liposarcoma—so starting this year I will launch a specialized research program on liposarcoma. I hope to continue accumulating experience in more clinical practice and further improve the treatment outcomes for liposarcoma.