Three Years of Pure TCM Treatment for Low-Differentiated Gastric Adenocarcinoma: The Case of Mr. Yang

Mr. Yang, male, a farmer from Dandong, Liaoning Province, born in 1946, first visited on March 5, 2019. He had long eaten pickled foods such as suan cai (pickled napa cabbage), and was Helicobacter pylori positive.

On November 28, 2018, he went to Dandong Central Hospital for gastroscopy due to discomfort. The electronic gastroscopy report (outpatient no. 102733788, exam no. 390534) showed congestive and edematous gastric fundus mucosa with scattered petechiae; congested and edematous gastric body mucosa with scattered petechiae and turbid mucus pool; multiple shallow, irregular, depressed ulcers on the lesser curvature of the anterior wall of the mid-gastric body, covered by a thin white coat with mild surrounding erythema and edema.

Biopsy at Dandong Central Hospital (pathology no. 42834) showed atrophic gastritis with intestinal metaplasia in the gastric antrum and low-differentiated adenocarcinoma of the gastric body. On December 10, 2018, pathology consultation at the First Affiliated Hospital of China Medical University (consultation no. 141807099) confirmed low-differentiated adenocarcinoma of the gastric body, of relatively high malignancy.

The patient's wife had previously been diagnosed with colorectal cancer and, after standard Western surgery and chemotherapy, died within months. So when the patient himself was diagnosed with low-differentiated gastric adenocarcinoma, the family decided against any further Western treatment and chose TCM instead.

After several months with a TCM doctor in the province, results were poor and the patient's symptoms worsened. His daughter then came to me for help.

The previous doctor's prescription: Long Dan Cao (Gentianae Radix) 10 g, Chai Hu 10 g, Huang Qin 10 g, Zhi Zi 10 g, Che Qian Zi 15 g, Jiu Da Huang (wine Rhubarb) 10 g, Sheng Di Huang (Rehmanniae Radix recens) 20 g, Ze Xie 10 g, Sheng Gan Cao 10 g, Dan Shen 25 g, Mai Dong (Ophiopogonis Radix) 10 g, Huang Jing (Polygonati Rhizoma) 10 g, Yuan Hu (Corydalidis Rhizoma) 15 g, Zhi Qiao (Aurantii Fructus) 10 g, Qing Pi 10 g, Bing Lang 10 g, Mu Xiang 10 g, Yu Jin 10 g, San Leng (Sparganii Rhizoma) 15 g, E Zhu (Curcumae Rhizoma) 15 g, Bai Hua She She Cao (Hedyotis diffusa) 15 g, Ban Zhi Lian (Scutellariae barbatae Herba) 15 g, Ku Shen (Sophorae Flavescentis Radix) 10 g.

After taking the above, the patient saw no clear effect. His appetite worsened; he had progressive weight loss, hiccups, epigastric pain, gastric distension and heartburn. Sleep was acceptable. After the medication, new symptoms appeared: dry eyes, itchy skin, scalp papules, loose stools, bitter mouth and dark urine.

Based on his symptoms, I drafted: Dang Shen (Codonopsis Radix) 15 g, Bai Zhu 10 g, Zhi Gan Cao (honey-fried licorice) 6 g, Fu Ling 10 g, Xuan Fu Hua 6 g (wrap-decoct), Dai Zhe Shi 6 g (same wrap-decoct), Zhu Ru 6 g, Fa Ban Xia 6 g, Chen Pi 6 g, Jiao San Xian (charred Shen Qu, Mai Ya, Shan Zha) each 10 g, Bai Ji (Bletillae Rhizoma) 6 g, Sha Ren (Amomi Fructus) 3 g, Tan Xiang (Santali Lignum) 3 g, Dan Shen 30 g, Sheng Huang Qi (raw Astragali Radix) 30 g, Chao Yi Yi Ren (stir-fried Coix) 60 g, Dang Gui 10 g, Mu Xiang 10 g, Shi Di 10 g, Ding Xiang 6 g, Bai Hua She She Cao 10 g, Ban Zhi Lian 10 g, Teng Li Gen (Actinidiae argutae Radix) 30 g, Fo Shou (Citri Sarcodactylis Fructus) 30 g, Hou Po 15 g, Jiang Huang (Curcumae longae Rhizoma) 6 g, Jiang Can (Bombyx batryticatus) 10 g, Chan Yi (Cicadae Periostracum) 6 g, Sheng Jiang 7 slices, Da Zao 7 pieces.

The above combines and modifies Liu Jun Zi Tang, Xuan Fu Dai Zhe Tang, Dan Shen Yin, Er Chen Tang, Sheng Jiang San and Ding Xiang Shi Di San, aimed at resolving the patient's symptoms. At the same time, he took anti-cancer patent medicines such as Fu Ban Mao Jiao Nang (Mylabris compound capsule) and Ping Pian tablets. I also had a pill made from Xuan Shen, Zhe Bei Mu, Chuan Bei Mu (Fritillariae cirrhosae Bulbus), Mu Li, Bie Jia (Trionydis Carapax), Liang Tou Jian (Anemones Raddeanae Rhizoma), Wu Gong, Quan Xie, artificial She Xiang (Moschus), artificial Niu Huang (Bovis Calculus), Ru Xiang (Olibanum), Mo Yao (Myrrha), Wu Zei Gu (cuttlebone), Bai Ji, Chan Su (Bufonis Venenum), Ma Lu (Julidae), Ding Xiang, Ji Nei Jin (Gigeriae endothelium Corneum gigeriae galli) and Chen Pi. This pill is essentially a combined, modified version of Xi Huang Wan, Xiao Luo Wan and Wu Ji San.

I told the patient that once symptoms eased, he should stop the decoction and persist with the patent medicines for a while, fighting cancer gently. Soon after taking the above, his symptoms largely disappeared, so he stopped the decoction and continued with pills and capsules. At one point he reported swollen feet; I initially judged this a side effect of the Mylabris compound capsule and told him to stop it. After six months on this regimen, his weight had clearly recovered and his strength was much better; he no longer looked like a patient, doing farm work in the village every day.

The patient still does not know his true diagnosis, but out of trust he cooperated and kept taking the medicine until June 2021. After that he stopped on his own. In September 2022, a family member of another gastric cancer patient came to see me. I asked after this patient; they said he had gained weight, was in excellent health, his old symptoms were gone, he was disease-free and often went up the mountain to gather mushrooms.

For this patient, the goal was simply to improve quality of life and modestly extend survival, so both he and the family were satisfied. During treatment we did not repeat imaging and did not track progression. Because the patient did not know his true diagnosis, he had no fear or panic, and his state was good. He himself refused more medicine, and since he was doing well, we asked the family to watch his weight closely and return if symptoms recurred or progressive weight loss set in.