The Role of the Chinese Patent Liushen Wan in Treating Leukemia, Esophageal Cancer, and Other Cancers
Liushen Wan is a commonly used Chinese patent medicine, a confidential prescription product of Lei Yunshang Pharmaceutical Group. Its function is to clear heat and cool, resolve toxicity, reduce swelling, and stop pain. It is commonly used to treat rotten-throat scarlet fever, sore swollen throat, throat wind and throat abscess, single and double tonsillitis, childhood heat boils, sores and deep-set boils, breast abscess and back abscess, and nameless swellings and toxins. Traditional Chinese medicine mostly uses it for throat and external-surgery diseases; it can be taken internally or crushed, mixed with vinegar, and applied externally.
Modern pharmacological research has found that Liushen Wan has a good anti-cancer effect, especially on acute leukemia. Besides leukemia, Liushen Wan can also be used for oral cancer, laryngeal cancer, tonsillar cancer, upper digestive-tract tumors, nasopharyngeal cancer, breast cancer, intestinal cancer, and other tumors.
The ingredients of Liushen Wan include musk (shexiang), cow bezoar (niuhuang), borneol (bingpian), pearl (zhenzhu), toad venom (chanchu), realgar (xionghuang), and herb soot (baicaoshuang). Among them, musk, cow bezoar, toad venom, and realgar are all commonly used anti-cancer Chinese herbs. Borneol cools blood, reduces swelling, and relieves pain. Pearl, when used in pills and powders, has the effect of drying dampness and astringing; it can be used for damp sores with itching and for ulcers that will not heal for a long time, and is also one of the herbs commonly used in oncology. Herb soot is the layer of charcoal ash scraped from the bottom of cooking pots when rural families lit fires for cooking in the past. It stops bleeding, disperses food accumulation, clears toxin, and scatters fire; it mainly treats vomiting blood, nosebleed, bloody stool, metrorrhagia, leukorrhea, food retention, dysentery, jaundice, sore swollen throat, mouth and tongue ulcers, chronic lower-leg ulcers, scaly scabby head sores, and external traumatic bleeding.
Thus the formula Liushen Wan is especially suitable for heat-toxin-type tumor patients presenting with sore throat, mouth and tongue ulcers, ulcer bleeding, and similar symptoms. Its most frequent use is in leukemia; both the toad venom and realgar in Liushen Wan have good anti-leukemia and anti-tumor effects.
Modern pharmacological research has found that Liushen Wan can induce apoptosis of leukemia cells and can also inhibit tumor angiogenesis. In vitro tests have confirmed that Liushen Wan can inhibit the proliferative activity of the hepatoma cell line BEL7402, the leukemia cell line HL-60, and the gastric cancer cell line SGC7901.
When Liushen Wan is used to treat leukemia, the daily dose should be 90–180 pills. The hematology departments of several hospitals, including Tianjin TCM Hospital in China, have used Liushen Wan for leukemia; results show that Liushen Wan works reasonably well for acute non-lymphocytic leukemia, and a small number of patients taking Liushen Wan alone achieved disease remission. Liu Xiuwen and colleagues reported that using Liushen Wan together with the HOAP regimen for leukemia achieved an effective rate of up to 90.48%.
Liushen Wan can also be used for patients with laryngeal cancer, esophageal cancer, tonsillar cancer, or cardia cancer who have difficulty swallowing; such patients can take the medicine by letting it dissolve in the mouth.
Besides that, Liushen Wan can also treat the shingles that often appears in cancer patients. To treat shingles, 6 g of Liushen Wan may be ground into fine powder, mixed into a paste with 50 ml of vinegar, and applied externally to the affected area three times daily; stop once symptoms disappear. Some people also use Liushen Wan for cancer complications such as chemotherapy-induced vasculitis, applied the same way as for shingles.
Because toad venom and realgar belong to "using poison to attack poison" substances, the formula Liushen Wan is traditionally classified among the poison-to-attack-poison formulas. Generally, physically weak patients, children, and elderly patients should use it cautiously and only under a doctor's guidance.
Liushen Wan is covered by medical insurance, so for most cancer patients with insurance, ways can be found to have this patent medicine prescribed through the medical-insurance system, which can lighten the economic burden on cancer patients.
Because it contains powerful poisons such as toad venom and realgar, Liushen Wan must not be taken in excess, nor should it be used together with other patent medicines containing toad venom and realgar, so as to avoid poisoning from an overdose. The pills of Liushen Wan are very small—1,000 pills weigh only 3.125 grams—so as long as the number of pills taken each time is strictly controlled, poisoning is unlikely. However, long-term use of Liushen Wan must be under a doctor's guidance, so as to avoid chronic poisoning from long-term accumulation of arsenic compounds.
The New Compiled National Chinese Patent Medicines gives the standard internal use and dosage of Liushen Wan: oral, three times daily, swallowed with warm boiled water. For a 1-year-old infant, 1 pill per dose; 2 years old, 2 pills; 3 years old, 3–4 pills; 3–8 years old, 5–6 pills; 9–10 years old, 8–9 pills; adults, 10 pills per dose. It may also be applied externally to red, swollen skin: take ten or more pills, dissolve them in a little cold boiled water or rice vinegar, and dab and apply around the affected area several times a day, keeping it moist until the swelling subsides. If the redness and swelling is about to suppurate or has already ulcerated and broken open, it must not be applied externally again, because realgar and toad venom entering the bloodstream through the broken skin can cause poisoning.
However, for tumor patients such as those with leukemia, the dosage given in the national pharmacopoeia is far below the effective dose; generally, for adult cancer patients, a daily dose of 90–180 pills is needed to be effective. For pediatric cancer patients, a daily dose of 60–120 pills is also needed to be effective.
The common reactions to realgar poisoning are eyelid edema, blurred vision, skin flushing, dry mouth and throat, stomach burning, difficulty swallowing, violent vomiting, abdominal pain, diarrhea, with rice-water-like stool that may be bloody. These are accompanied by dizziness, headache, and generalized fatigue.
The common reactions to toad-venom poisoning are nausea, vomiting, abdominal pain, diarrhea, ascites, shock, chest tightness, palpitations, cyanosis, and arrhythmia; the ECG may show ST and T changes and conduction block like digitalis poisoning. In severe cases it can lead to Adams-Stokes syndrome and respiratory and circulatory failure. There are also nervous-system reactions such as dizziness, headache, drowsiness, sweating, numbness of the lips and limbs, and convulsions. If toad venom enters the eye by mistake, it can cause redness and swelling of the eye and even blindness. Occasional cases of exfoliative dermatitis occur.
In addition, although the borneol in Liushen Wan is not as toxic as realgar and toad venom, it still has a certain toxicity. An excessive dose of borneol harms the digestive tract and can cause nausea, vomiting, abdominal pain, enlarged liver and spleen, and can also cause high fever and convulsions, confusion, and muscle spasms; in severe cases it can cause death from respiratory failure.
Tumor patients taking Liushen Wan should closely watch for the above toxic side effects; if mild poisoning reactions appear, the medicine should be stopped, and the dose reduced when used again. If the toxic side effects are relatively obvious, they should seek medical attention promptly so a doctor can give the appropriate antidotal treatment. Moreover, when taking this medicine long-term, it is best to take it for a while and then pause for a while, so as to avoid cumulative poisoning.
The treatment of tumors will never be smooth sailing; there is no absolutely safe treatment plan. Treating a tumor inevitably requires taking some risk, and patients inevitably have to bear some suffering. If a patient is too fragile and hopes for a perfectly smooth tumor-treatment process with no side effects at all, that is basically putting the doctor in an impossible position; few doctors dare to take responsibility for such a patient.
Therefore, it is necessary for tumor patients and their families to understand the properties and toxic side effects of some commonly used anti-cancer drugs, to understand the risks that are hard to avoid during treatment, and to understand that medicine inherently carries risk.