Exploring the Same-Treatment-of-Different-Diseases Approach in Leukemia and Neuroblastoma

Leukemia and neuroblastoma are regarded as two different diseases in Western medicine, but their clinical syndromes overlap: in the acute phase both present fever, anemia, bleeding and pain. In the spirit of TCM pattern differentiation, such symptoms represent alternating or concurrent occurrences of excess evil-qi (fire-heat excess) and righteous-qi deficiency (qi and blood insufficiency). Treatment must simultaneously address both dispelling evil and supporting the righteous: evil-dispelling relies mainly on heat-clearing, detoxifying and heat-clearing, blood-cooling herbs; righteous-supporting uses yin-nourishing, blood-enriching herbs. Used together, they can relieve the patient's clinical symptoms.

The fever of leukemia and neuroblastoma differs from externally-contracted fever; simply using diaphoretic exterior-releasing methods is not only ineffective but can easily cause more complications. This kind of fever is internal heat due to fire-toxin and fetal-toxin in TCM terms; large doses of heat-clearing, detoxifying, anti-cancer herbs should be used. The ones I have found clinically effective mainly include: Daqingye (Forsythia Leaf / Isatis Leaf), Banlangen (Isatis Root), Qingdai (Indigo), Banzhilian (Scutellaria Barbata), Banbianlian (Lobelia), Baihuasheshecao (Oldenlandia), Shandougen (Sophora Tonkinensis Root), Huaimi (Sophora Flower Bud), Pugongying (Dandelion), Zihu Diding (Viola), Yejuhua (Wild Chrysanthemum), Chonglou (Paris Rhizome), Baitouweng (Pulsatilla), Jinyinhua (Honeysuckle), Machixian (Portulaca), Huanglian (Coptis), Huangqin (Scutellaria), and Zhizi (Gardenia). Heat-clearing/detoxifying herbs alone are not enough; they should be combined with heat-clearing, blood-cooling herbs such as Mudanpi (Moutan Bark), Chishao (Red Peony), Zicao (Lithospermum), Danshen (Salvia), Shengdi (Raw Rehmannia), and Xuanshen (Scrophularia).

If the patient's temperature is high, one may add Qinghao (Sweet Wormwood), Baiwei (Cynanchum), Fuping (Duckweed), and Chantui (Cicada Slough), herbs that release the exterior and clear heat; warming herbs such as Guizhi (Cinnamon Twig), Mahuang (Ephedra), and Zisu (Perilla) should be used cautiously. Yin-nourishing, blood-enriching herbs mainly consider Shihu (Dendrobium), Maidong (Ophiopogon), Tiandong (Asparagus), Mohanlian (Eclipta), Nüzhenzi (Ligustrum), Taizishen (Pseudostellaria), Xiyangshen (American Ginseng), Shudi (Processed Rehmannia), Huangjing (Polygonatum), Yuzhu (Polygonatum Odoratum), and Jiaogulan (Gynostemma). Xianhecao (Agrimonia) must be used in heavy dosage; whether adult or child, it may be used at 100 g or more. But if the patient has a weak spleen and stomach, it must be paired with other herbs. Xionghuang (Realgar) is a commonly used herb when high fever in leukemia patients is hard to abate; it is usually paired with Qingdai (Indigo) and Chansu (Toad Venom), and quickly suppresses cancer cells. Whether this combination also acts against neuroblastoma I have not yet confirmed; if I gain definitive effective experience in future, I will write again.

The acute phase of leukemia and neuroblastoma is often extremely dangerous: the patient's high fever is hard to abate, the blood count plummets, and the gums, throat, mouth and anus develop erosions and ulcers; bleeding symptoms such as nosebleed, hemoptysis, hematemesis and melena appear, and purpura shows on the skin. Late-stage patients have a grayish-white complexion and purplish-dark plaques on the body, facing death at any moment—a poor prognostic sign. The physician must act decisively to turn the tide; when necessary, emergency warm-disease formulas such as Angong Niuhuang Wan (Peaceful Palace Bovine Bezoar Pill), Zhibao Dan (Precious Pill) and Zixue San (Purple Snow Powder) must be used. Although the disease is dangerous, it can often be quickly turned around; some leukemia patients I treated showed good results after only three to five doses, moving from danger to safety.

When leukemia and neuroblastoma present high fever and anemia, warming herbs should be used cautiously: Fuzi (Aconite), Ganjiang (Dried Ginger), Rougui (Cinnamon Bark), Xixin (Asarum), and Lurong (Deer Antler) often worsen bleeding, and Renshen (Ginseng) and Huangqi (Astragalus) can make some patients feel unbearably hot and dry. Sheng Shigao (raw Gypsum) and Zhimu (Anemarrhena) can relieve temporary high fever, but many patients develop diarrhea as a side effect. This disease belongs to TCM's heat entering the ying-blood level; formulas such as Qingying Tang (Nutrient-Level-Clearing Decoction), Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction), Liangxue Dihuang Tang (Blood-Cooling Rehmannia Decoction), Huanglian Jiedu Tang (Coptis Detoxification Decoction), Wuwei Xiaodu Yin (Five-Ingredient Detoxification Drink), Qinggu San (Bone-Clearing Powder), and Biejia Qinghao Tang (Turtle Shell and Sweet Wormwood Decoction) should form the basis.