Protecting the Liver, Kidney and Stomach: The More Medicinals Used in TCM Anti-Cancer Treatment, the Greater the Chance of Success

TCM prescriptions that use many medicinals and are broad in scope have always been easy targets of criticism. Even a famous physician of the stature of Shi Jinmo could not escape censure, because he was fond of using large formulae.

Those TCM physicians accustomed to classical formulae especially looked down on practitioners who used broad prescriptions. And patients and their families, for economic reasons, naturally preferred small prescriptions.

But after years of clinically treating advanced cancer, I have come to deeply feel that large, multi-herb formulae are actually of great benefit to cancer patients.

I have also come to feel that when master physicians such as Shi Jinmo and Li Dongyuan used large formulae, they did so for good reason.

The Qing dynasty physician Xu Lingtai wrote an essay titled "On Why One Should Not Become a Famous Physician." It is a remarkable piece. Frankly, not everyone who practices medicine can appreciate what Xu Lingtai was getting at.

Only after a physician has himself become a well-known name can he deeply understand the many phenomena Xu describes.

Xu wrote: "Thus, when a family has only a mild or minor illness, they do not immediately call in a renowned physician. They wait until the condition has become critical, until nearby doctors are helpless, and the whole family believes it to be dangerous, and only then do they seek him. But when everyone considers a condition dangerous, it is truly dangerous. Moreover, the illness has usually dragged on for a long time, with many doctors tried and many medicines tested; mistake has piled on mistake, the condition has shifted many times, and it has already become a deranged, refractory disease. Does a famous physician truly possess the art of raising the dead? The patients' families do not understand this truth; they assume that such a great name must have the power to turn back heaven. If he, too, is helpless like the other doctors, how is he any different from the rest?"

I quote this passage at such length because it hits the nail on the head. Its meaning is this: ordinary people generally do not seek out famous physicians for mild illness; they wait until their condition is so critical that other doctors can do nothing, and only then do they turn to the famous doctor.

Over the years, many patients have come to me saying that they have already consulted every doctor of both Chinese and Western medicine, and that coming to me is their last stop; they hope I can work a miracle. The degree of difficulty in these cases is daunting.

There was once a lymphoma patient who had known me for two years but never sought treatment. Over those two years she saw doctors everywhere in her hometown. Only at the very end, when she told me she was already terminally ill, did she come. She said that if I could cure her, I would have passed the severest test and could be counted a top-tier master of TCM.

I could only give a wry smile at such a patient. Cancer is already a grave disease that leaves many doctors helpless; to wait until the patient is dying and has been treated by others to the point of being bedridden, and only then ask me to treat her, is surely to ask the impossible of me.

I believe that most of those who criticize great medical masters like Shi Jinmo and Li Dongyuan for using complex formulae simply cannot appreciate how complex the conditions faced by a famous physician really are.

Many of us who study TCM readily invoke the tradition's principle of the "six conditions in which one should not treat" to turn away gravely ill patients. This kind of evasion of the difficult in favor of the easy is a heartless way to practice.

From the standpoint of professional ethics, once a person has studied medicine, whenever a patient comes sincerely seeking help, no matter how severe the condition, one must not look for excuses to turn them away; however hard it may be, one must try to find a way to relieve the patient's suffering.

As the son of a cancer patient, after my own mother reached the terminal stage and I had been turned away on every side in search of treatment, I genuinely have little patience for those who evade severe cases.

A famous physician can hardly turn away gravely ill patients. And gravely ill patients can hardly be cured by ordinary treatment strategies.

Many of the patients seen by masters like Shi Jinmo and Li Dongyuan were already so severe as to be nearly untreatable. By boldly using large, broad formulae without being bound by convention, they often turned the tide and saved the patient's life. This is precisely where they excelled, and it is what we should learn from.

But Li Dongyuan has been dead for nearly a thousand years, and Shi Jinmo for decades, yet criticism of their large and complex prescriptions is still common. It is truly regrettable.

I myself often use large prescriptions, and sometimes with considerable effect.

Five years ago a patient with a giant liver tumor (16 cm across) came to me. One prescription contained more than sixty Chinese herbs. After several months of treatment, the tumor shrank to 12 cm, the patient gained weight, and was able to return to work. Later the patient insisted on undergoing interventional therapy; immediately after the intervention things went badly, and within two months he was dead.

Recently I had two patients for whom I used more than fifty herbs; in under half a year their tumors nearly completely vanished. By contrast, when I tread carefully and try to follow every rule and use very few herbs, the effect is poor.

When the late Doctor Liang Xiuqing treated cancer, he routinely used sixty to over a hundred herbs at once; the sheer complexity of his formulae was astonishing, yet he cured many cancers.

The late Doctor Yue Meizhong told of a folk elderly woman who contributed a secret family formula using dozens of medicinals with remarkable effect. Once the formula was made public, a swarm of TCM theoreticians rose up to attack it. Yet for all their erudition, these worthies simply did not achieve as good results as she did. This shows that theoreticians and practitioners are truly different.

In recent years I have grown rather afraid of using large prescriptions, because too many patients have been coached by various "experts." Every time I write a broad formula, some senior colleague sneers and dismisses it as reckless.

No one has a very high success rate in treating cancer, so in this age of strained doctor-patient relations, everyone fears that after some armchair critic offers a few opinions, the patient will come and make trouble for us.

Over time I have learned to tailor prescriptions to the person. For those I do not know well, the first prescription always follows a famous classical approach, utterly unimpeachable; senior masters praise it to the skies, but honestly, it does not cure cancer.

It lacks the effectiveness of the large formulae I wrote in my younger days, when I was fearless as a newborn calf. Now I only dare write large prescriptions for patients who trust me completely. It is a kind of tragedy.

Cancer is a disease that neither traditional nor modern medicine can treat very successfully. Yet there are indeed many fortunate patients who, through combined Chinese-Western treatment, snatch themselves back from the brink of death.

Let me mention in passing: those who say that once you have cancer you should not be treated, just eat, drink and be merry for the rest of your days, are, for the most part, people who talk standing up and do not know what backache is. Once they themselves get cancer, they immediately change their tune and actively seek treatment.

Having treated cancer for all these years, I have seen every kind of person. Those who brag before falling ill that they do not fear death cannot keep up the bragging once they are sick.

We must admit that neither traditional nor modern medicine has yet probed cancer deeply enough to find a universal method that can eradicate it the way we eradicate minor ailments.

Whenever news reports that some expert in some country has made a major breakthrough in treating cancer and similar diseases, I take such news calmly.

Because there have been many such reports in the past. In reality, a so-called effective regimen usually only extends survival by a few years in a subset of patients. It is still a long way from universally curing cancer.

Therefore, none of the current medical theories about cancer deserves to be treated as an infallible authority. To improve cancer patients' chances of survival, the best approach is to act on multiple fronts.

My own firsthand experience is that, for cancer patients, adopting a multi-pronged, multi-approach combined treatment offers a much greater chance of success than a single therapeutic strategy. In fashionable medical terminology, this is called multi-target therapy.

I have followed up many recovered cancer patients, and some survived on a single herb. But when their experience was applied to other patients, it did not work.

Such low-probability events, as our folk saying has it, are the luck of a lifetime when the ancestral grave sends up auspicious smoke.

A physician must do everything possible to raise the effective rate of treatment. So we cannot just hand out a few single-herb or folk recipes and let the patient gamble on such luck. One effective way to raise the success rate against cancer is to combine various therapeutic approaches in prescribing.

When the late Doctor Sun Bingyan treated cancer, he always liked to combine the use of toxins, giving patients several or even more than ten poisonous medicinals, while at the same time using decoctions to regulate and support the patient's constitution.

Using this method throughout his career, Doctor Sun successfully saved nearly a thousand critically ill patients; some survived for thirty or forty years after his treatment. That is no small achievement.

But even a specialist as effective as Doctor Sun, who devoted himself to cancer, did not have a high success rate. Over his lifetime he treated as many as 400,000 patient visits, the great majority of them cancer patients, yet he successfully pulled back only about a thousand. The ratio is not high.

Yet compared with ordinary doctors, he was a major achiever. Looking across the globe, there are not many doctors who can bring nearly a thousand late-stage cancer patients back from the brink.

Among the cancer patients who sought out Doctor Sun, there were hardly any early-stage cases. I know this firsthand: in an age dominated by modern medicine, we TCM physicians hardly see an early cancer patient all year. Almost everyone comes to us only when the disease is terminal and every other method has failed.

Faced with such patients, if one does not use large, combined-approach prescriptions, what better method is there?

But using large prescriptions is not the same as abusing medicinals. Large prescriptions still require pattern differentiation and treatment; one must know what problems the patient has and which medicinals may help relieve them.

Moreover, large prescriptions must be introduced gradually. One must not recklessly hand the patient a super-sized formula all at once. A broad prescription should be built up slowly from a small one, carefully observing the patient's response, step by step.

The physician's primary goal in prescribing is safety and efficacy; both matter. For safety, the doctor must constantly know the patient's response to the medication. For efficacy, the doctor must likewise constantly know the patient's response after taking it.

Nowadays TCM anti-cancer treatment is mostly delivered in outpatient settings, and this approach has a problem: the doctor can hardly observe the patient's response after taking the medicine. Generally one sees the patient once and then does not see them again for a long time. Some patients even come expecting that after the doctor writes a single prescription, they will rely on that one formula to cure themselves from then on.

From the attitude most patients take toward TCM, I have deeply realized that making TCM work against cancer is no easy thing.

Many patients will spend hundreds of thousands or even millions without hesitation on modern medicine. But when they see a TCM doctor, what they hope for deep down is to cure their illness for very little money.

They are also willing to see the doctor only once; if nothing happens after a while, they conclude that TCM does not work. This way of seeking treatment ensures that TCM's anti-cancer efficacy cannot be brought out well.

Frankly speaking, for such patients I do not exert myself either. Rather than waste huge amounts of time on such fruitless effort, it is better to patiently and carefully treat the patients who follow me long-term, and get them better results.

Only through long-term follow-up, repeatedly adjusting the prescription, can one use the effective medicinals at adequate doses and bring the patient to the best possible state. I think many clinical doctors feel the same way.