A Five-Year Pure TCM Survival Case of Massive Hepatocellular Carcinoma Treated by Kang Liangshi

This case report was published in the China Journal of Traditional Chinese Medicine and Pharmacy (2012, 27: 3147-3149), under the original title "Professor Kang Liangshi's Experience in Treating Primary Liver Cancer by Combining Disease and Syndrome Differentiation."

The patient in this case was a 58-year-old woman. On May 14, 2004, she presented at a hospital in Xiamen for dull pain in the right hypochondrium lasting more than one month; she had a history of chronic hepatitis for many years. CT revealed a massive tumor in the right liver, with AFP 800 ug/L. Western medicine diagnosed primary liver cancer. Because it was discovered at an advanced stage, there was no surgical opportunity. She therefore consulted Professor Kang Liangshi for purely TCM treatment, hoping only to prolong her life.

Symptoms at the first visit: fatigue and lassitude, poor appetite, abdominal distension, loose and incomplete stools, thirst with polydipsia, poor sleep, paroxysmal vertigo, aching joints, muscle tension, sallow dark complexion, depressed mood, dark tongue, turbid greasy coating, wiry and slippery pulse.

Professor Kang differentiated the pattern as toxin-stasis binding in the liver and spleen, and planned treatment with the strategy of resolving stasis and detoxifying, while regulating the liver and spleen. The first prescription was a modified Xiaoxiao Shugan Tang (Nodule-Resolving and Liver-Soothing Decoction).

The formula was as follows: Jiujiecha (Sarcandrae Herba, 九节茶) 30 g, Longkuikui (Solanum nigrum, 龙葵草) 30 g, Banbianlian (Lobeliae Chinensis Herba, 半边莲) 30 g, Baihua Sheshengcao (Hedyotidis Herba, 白花蛇舌草) 30 g, Banzhilian (Scutellariae Barbatae Herba, 半枝莲) 20 g, Baqia (Smilacis Glabrae Rhizoma, 菝葜) 30 g, Xianhecao (Agrimoniae Herba, 仙鹤草) 30 g, Yiyiren (Coicis Semen, 薏苡仁) 30 g, Yujin (Curcumae Radix, 郁金) 10 g, Ezhu (Curcumae Rhizoma, 莪术) 10 g, Chaihu (Bupleuri Radix, 柴胡) 10 g, Mudanpi (Moutan Cortex, 牡丹皮) 10 g, Foshou (Citri Sarcodactylis Fructus, 佛手) 10 g, Sanqi fen (Notoginseng powder, 三七粉) 3 g. One dose daily, decocted in water. After taking it for some time, it was adjusted to one dose every 2-3 days.

The patient followed this approach, returning for follow-up every 3-6 months; each time Professor Kang made slight adjustments based on her symptoms. After five years of treatment, her hypochondriac pain was reduced, abdominal distension improved, diet and sleep returned to normal, and she could do some housework. Repeated CT scans all showed the tumor gradually shrinking, though it was not completely eliminated; she survived with the tumor, and AFP fell to 78 ug/L. At the time the article was published, the patient was still alive and continuing treatment with Professor Kang.

This patient was fortunate; pure TCM treatment was effective. Achieving such a good outcome with pure TCM in massive liver cancer is genuinely uncommon. Professor Kang's prescribing approach was basically the combination of syndrome differentiation and disease differentiation: he used some herbs to relieve the patient's symptoms, reducing her abdominal distension and removing damp-turbidity, and also used some Chinese medicines with a certain therapeutic effect on liver cancer.

In this formula, Jiujiecha is also called Caoshanhu (Sarcandra glabra); it clears heat and detoxifies, drains dampness and reduces swelling, and activates blood and resolves stasis. Longkuikui clears heat and detoxifies, fights cancer and reduces swelling, drains dampness and relieves jaundice, protects the liver and gallbladder, and also has a certain anti-tumor effect. Banbianlian, Baihua Sheshengcao, and Banzhilian are all Chinese medicines commonly used in recent years for treating jaundice, ascites, and cancerous masses. Baqia, also called Jingangteng, is rich in saponins and flavonoids and has a marked relieving effect on edema; TCM holds that it clears heat and detoxifies, reduces swelling and dissipates nodules, drains dampness and reduces edema, strengthens the sinews and bones, and strengthens the spleen and stomach; in recent years it has also been widely used against cancer. Xianhecao is also called Tuoli cao; people in the Jiangsu-Zhejiang region brew it as tea to boost physical strength. TCM holds that Xianhecao stops bleeding and also supplements deficiency; modern pharmacological research shows it has some anti-tumor and immunity-enhancing effects. Yiyiren is the Job's tears we eat daily; it fortifies the spleen and promotes urination, fights cancer and reduces swelling. Yujin and Ezhu both belong to the Zingiberaceae, Curcuma genus; traditional TCM holds that both activate blood and resolve stasis, break up accumulation and reduce swelling, and Yujin also soothes the liver and relieves constraint. Chaihu is an essential herb for treating liver disease; it soothes the liver, relieves constraint, and harmonizes the shaoyang. Mudanpi cools blood and reduces swelling. Foshong soothes the liver and moves qi, relieves distension and dissipates stagnation. Sanqi activates blood and resolves stasis, reduces swelling and relieves pain.

Such a formula comprehensively applies the knowledge of traditional TCM theory and modern pharmacological research, with strong targeting against liver cancer and also against this patient's symptoms, so in the end it did achieve a good therapeutic effect. The patient's tumor could not be completely eliminated, but being able to survive with the tumor for more than five years and, up to the publication of the case report, remain in a relatively good survival state, was already fortunate.

Another commendable point of Professor Kang's case is that he only had the patient take one decoction daily at the beginning, then changed to one dose every 2-3 days, gradually reducing the dosing frequency. This treatment approach is also one I commonly use: letting the patient take medication intermittently with breaks reduces damage to important organs such as the liver, kidneys, and stomach. Chronic disease is treated slowly, and the result is actually better.

It should be pointed out that the overall effective rate of pure TCM treatment for liver cancer is not high; the patient in this case was among the fortunate ones. Her choice of pure TCM was related to the fact that the cancer was already advanced when discovered, at which stage few medical options remain. If a patient is diagnosed at an earlier stage, integrated Chinese-Western medicine and a comprehensive treatment plan should still be considered, as the effective rate is higher.