Li Furen's Qushi Bushen Tang for Hot Flashes after Orchiectomy in Prostate Cancer
Dr. Li Furen, a disciple of Mr. Shi Jinmo, once treated a number of prostate cancer patients. He had an empirical formula called "Qushi Bushen Tang" (Castration-Supplementing Kidney Decoction). The formula consists of: Shengdihuang (raw Rehmannia root) 15g, Shudihuang (prepared Rehmannia root) 15g, Shanzhuyu (Asiatic cornelian cherry fruit) 12g, Nuzhenzi (glossy privet fruit) 12g, Huangjing (Solomon's seal rhizome) 10g, Tusizi (Cuscuta seed) 12g, Gouqizi (wolfberry fruit) 12g, Digupi (wolfberry root bark) 10g, Fuling (Poria) 15g, Hangbaishao (white Paeonia root) 15g, Fuxiaomai (light wheat) 30g, Zexie (Alisma rhizome) 10g, Gancao (licorice root) 3g.
This formula regulates and supplements yin and yang, and harmonizes qi and blood. It is indicated for patients after orchiectomy for prostate cancer who present with kidney deficiency and an imbalance of yin, yang, qi and blood, manifesting as paroxysmal hot flashes, steaming heat with sweating, insomnia and irritability, dizziness and lower back soreness, and impotence.
This formula was modified on the basis of Liuwei Dihuang Wan (Rehmannia Six-Ingredient Pill, composed of Shudi, Shanzhuyu, Fuling, Zexie, Mudanpi, and Huaishan Yao). Its composition is essentially the same as that of Liuwei Dihuang Wan: it nourishes and supplements the liver and kidney, simultaneously drains kidney turbidity, enriches yin and clears heat, and astringes yin to stop sweating, so as to achieve the goal of stopping sweating. Liuwei Dihuang Wan itself also treats bone-steaming hot flashes; Zhibai Dihuang Wan, which is an enhanced version of Liuwei Dihuang Wan, works even better for bone-steaming hot flashes. The author has himself used Zhibai Dihuang Wan alone to treat postoperative hot flashes and sweating in prostate cancer patients, with effectiveness.
This formula heavily employs kidney-supplementing herbs of TCM: Shudihuang, Huangjing, Shanzhuyu, Nuzhenzi, Tusizi, and Gouqizi all supplement the kidney. Fuling and Zexie drain kidney turbidity. Here it must be emphasized that when using Rehmannia-series formulas, if Fuling and Zexie are omitted, patients are prone to the side effect of itchy ears. Shengdihuang and Digupi clear heat and down-fire; Huangjing and Baishao nourish blood and enrich yin; Baishao and Fuxiaomai are both commonly used to astringe yin and stop sweating; Gancao harmonizes the other herbs. Thus this composition addresses both the root and the manifestation.
After castration (orchiectomy) for male prostate cancer or ovarian castration for female ovarian cancer, patients all develop hot flashes and sweating, along with insomnia and irritability. In essence, this is caused by disordered sex-hormone secretion after surgery. Rehmannia-series formulas have some effect on regulating sex hormones. However, the most effective medicine the author has found for hot flashes and night sweats after castration for ovarian cancer is not a Rehmannia-series formula but Baihe Gujin Wan. For post-orchiectomy hot flashes in prostate cancer, Rehmannia-series formulas are indeed effective, and Baihe Gujin Wan is occasionally effective as well.