A Case of Marked Effect in Treating Peritoneal Mesothelioma with Ascites Using Pure TCM

This is part of a case I treated for a long-time reader of this blog; the patient is still doing well.

The patient, a 43-year-old man, had peritoneal mesothelioma. When he first came to me, his CA125 was 66.47 (normal reference 0–35), with multiple hepatic nodules (the largest 1.2 × 1.0 cm), mild splenomegaly, and ascites. After one month of pure TCM treatment under my formula, a repeat test showed CA125 had fallen to 46.32, the largest liver nodule had shrunk to 0.8 × 0.6 cm, and the ascites had decreased. After another month of continued treatment, CA125 returned to the normal range at 34.89, and the largest liver nodule measured 0.8 × 0.8 cm. The ascites basically held steady, but the patient's stamina improved markedly, his weight rose, and his overall condition improved greatly.

This patient had received chemotherapy a little over a year earlier, which improved his condition. After that, for more than a year without Western treatment, he relapsed and developed ascites; he was then prescribed treatment by a famous TCM professor in Beijing, to no avail. He came to see me at the beginning of August this year.

On the first visit, his pulse was scallion-stalk (kong) and soft; the underside of the tongue was pale purple, the dorsum covered with fine white coating, with thick coating at the root, no teeth marks, and varicose veins under the tongue. He disliked drinking water. He was anemic, his voice lacked luster, his nails showed obvious transverse ridges, his hands and feet were not warm, the lower abdomen in the bladder region was markedly distended, and his urine output was small. He had self-taken Jinkui Shenqi Wan without effect; he felt fatigued, his stools were loose yet very difficult to pass. He had a bowel movement once a day, in small amounts. His lower back ached and felt distended after walking. His appetite was normal, and he reported previously having bad breath.

Synthesizing his pulse and facial presentation, I identified him as belonging to the yin-type among cancer patients, and decided to treat him according to the "Quansheng" (Life-preserving) school approach, modifying Yanghe Tang based on his symptoms.

First prescription:

Lujiaojiao (Colla Cornus Cervi) 12 g, melted separately; Baijiezi (Semen Sinapis Albae) 8 g; Shudi (Radix Rehmanniae Praeparata) 40 g; Mahuang (Herba Ephedrae) 2 g; Rougui (Cortex Cinnamomi) 4 g, added later; Sheng Gancao (raw Radix Glycyrrhizae) 4 g; Paojiang (Rhizoma Zingiberis Praeparatum) 2 g; Laifuzi (Semen Raphani) 30 g; Niuxi (Radix Cyathulae) 15 g; Duzhong (Cortex Eucommiae) 15 g.

One decoction daily, taken in the morning. Each evening, take Xihuang Wan (Yellow Jade Pill): starting at 6 g, increasing by 3 g every two days up to a maximum of 12 g. Take for seven days, then stop for seven days; stop immediately if diarrhea appears.

The patient began strict adherence to my instructions on August 10, 2013. After starting the herbs he sweated easily, so I had him add Sheng Huangqi (raw Radix Astragali) 30 g to the original formula; afterward the easy sweating disappeared. The stomach pain from his pre-existing gastric problem resolved, his stamina improved markedly, and his spirit brightened greatly. His stools became looser, but much easier to pass; his urine normalized, and the ascites slowly subsided. After seven days he stopped for seven days as instructed.

On August 24 he returned for another prescription. I added the Er Chen formula to the previous one.

Sheng Huangqi 30 g; Lujiaojiao 12 g (melted separately); Baijiezi 8 g; Shudi 40 g; Mahuang 2 g; Rougui 4 g (added later); Sheng Gancao 4 g; Paojiang 2 g; Laifuzi 30 g; Niuxi 15 g; Duzhong 15 g; Fabanxia (Rhizoma Pinelliae Praeparatum) 10 g; Chenpi (Pericarpium Citri Reticulatae) 10 g.

Xihuang Wan: 6 g each evening on days 1–2, 9 g on days 3–4, 12 g on days 5–6. On the sixth day he reported a poisoning-like reaction, feeling very unwell, dizzy and with a heavy lower back, so I stopped it.

After stopping, he went to the hospital for a check-up: ascites had subsided, the CA markers had fallen, and the liver nodules had shrunk.

On September 7 he resumed herbs; I told him to continue the August 24 regimen unchanged. Conditions continued to improve. This time he took the herbs for seven days without the previous toxic reaction, then stopped for seven days. On September 23 he asked again; I told him the formula was effective and not to change it, and to keep taking it.

On October 8, his follow-up showed the CA markers had returned to normal, though the spleen was still slightly enlarged and the liver nodules had not all resolved. On October 13 he asked again; because he showed slight blood stasis, I told him to add Danshen (Radix Salviae Miltiorrhizae) 20 g. On October 28 he consulted again; by now his stamina had greatly improved, and I judged the dispelling-evil component could be appropriately strengthened. I also told him to eat a low-protein, low-fat diet.

Prescription:

Lujiaojiao 12 g (melted separately); Baijiezi 8 g; Shudi 40 g; Mahuang 2 g; Rougui 4 g (added later); Sheng Gancao 4 g; Paojiang 2 g; Laifuzi 20 g; Dafupi (Pericarpium Arecae) 10 g; Chuanniuxi (Radix Cyathulae) 10 g; Duzhong 10 g; Fabanxia 10 g; Chenpi 6 g; Sheng Huangqi 30 g; Danshen 15 g; Sanleng (Rhizoma Sparganii) 6 g; Ezhu (Rhizoma Curcumae) 6 g; Shuihonghuazi (Fructus Polygoni Orientalis) 10 g; Chaihu (Radix Bupleuri) 6 g; Huangqin (Radix Scutellariae) 6 g.

When this patient developed multiple liver nodules, splenomegaly and ascites, he received no Western treatment of any kind, nor any diuretics. Because he had read my blog for over a year and trusted me deeply, and because he was determined to pursue pure TCM, I did not follow the modern standard approach to ascites with albumin infusion and diuresis. I relied purely on TCM pattern differentiation, identified him as yang-deficient, and treated him with modified Yanghe Tang.

In only two months—though, because I had him take herbs for seven days and stop for seven, the actual medication time was just one month—his overall condition improved, the CA markers fell continuously to normal, and the liver nodules shrank noticeably. This is a quite satisfactory result.

Now that his condition has recovered, on the basis of Yanghe Tang I am treating him to soothe and drain liver stagnant heat, soften hard masses and dissipate nodules, and activate blood and resolve stasis, in order to further improve the liver nodules and splenomegaly and ultimately eliminate the ascites.

The root of this success is that, upon seeing ascites, I did not blindly follow the modern-medical playbook of albumin and diuretics. I treated the disease to its root, addressing his yang deficiency at the source, restoring liver and spleen function, and softening the liver and shrinking the spleen. When the patient was deficient, I did not rush into aggressive evil-dispelling; that is why he recovered safely.

This shows that in treating cancer with TCM, only by combining pattern differentiation with disease differentiation can one achieve satisfactory results. The advantages of TCM in cancer treatment are evident in this case. Another soft-tissue tumor patient treated around the same time, after repeated radiotherapy, rapidly developed bone and lung metastases and deteriorated sharply; yet that patient's initial symptoms were far milder than this one's. When a conservative TCM protocol is correct, it can be of great help to middle- and late-stage cancer patients.