Severe Chronic Illness Calls for Strong Herbs: On Large Formulas and Heavy Dosages in TCM Tumor Treatment

When I first learned to use TCM to treat tumors, I liked to study from books. Later, after gradually coming into contact with some patients whose tumors had been treated very successfully with Chinese medicine, I liked to trace their treatment processes and study the formulas they used. Some had been cured by folk remedies, and some by particular TCM physicians. The formulas they used differed from one another, but some of the methods were things one cannot see in books.

Last month, I went to Penglai, Shandong, to follow up on the treatment of a terminal-stage gastric cancer patient. When the patient was operated on, after the surgeon opened the abdomen he found the belly already filled with tumors; surgery was of little significance, so he abandoned the attempt to resect them, sewed the patient up, and sent him for chemotherapy. After one course of chemotherapy the patient could not endure it, decided to give up chemotherapy, and went home to wait for death.

Later, on the advice of local people, the patient dug up the root of a herb called "Huai Liandou" in the Yantai-Penglai area and used it for treatment. After I personally went to Yantai-Penglai to verify it, I confirmed this herb to be Kushen (Radix Sophorae Flavescentis, Sophora root). The patient drank a decoction of Kushen alone and survived for five and a half years. Through the patient's family I learned that he used about one liang (about 30–50 g) of Kushen each time—far exceeding the conventional dose in the Chinese pharmacopoeia.

After several months of treatment with this folk remedy, the patient resumed normal agricultural labor, which was very strenuous. Because his family was poor, his living conditions were poor and his diet was plain. The family therefore thought that if he had not overworked, his survival might have exceeded five and a half years. But I myself do not think so; it may have been precisely because this patient long performed farm labor, ate a simple diet, and used Kushen in heavy dosage that he survived so long.

That a terminal-stage gastric cancer patient could survive five and a half years on single-herb Kushen is already a miracle. I believe that, whether in Chinese or Western medicine, it would be hard to achieve such a result in such a patient. The dose of Kushen this patient used far exceeded the pharmacopoeial amount. Kushen very easily causes gastrointestinal discomfort and indigestion; had the patient not long performed heavy physical labor, he could hardly have withstood this side effect.

Incidentally, nowadays many patients, upon learning they have cancer, are kept by their families as much as possible "resting and recovering"; the family is afraid their nutrition will fall short and afraid the patient will be tired. This notion is very wrong. A considerable number of tumors arise from overnutrition; patients get cancer precisely because for a long time they have eaten too nutritiously and exercised too little. Once they fall ill, if they redouble the nutrition and rest even more, the result is that the cancer is very hard to cure.

So cancer patients, during treatment, should engage in as much physical exercise as possible to promote their own metabolism, fully utilizing the body's natural recuperative powers to resist disease. When Professor Zhao Shaoqin treated cancer patients during his lifetime, he especially urged them to increase exercise. I myself, when treating cancer patients, also often urge them to exercise more. Life lies in movement; the benefits of exercise are enormous.

In Beijing I once met a pancreatic cancer patient who, after three years of treatment by a now-deceased senior TCM physician at Beijing Chaoyang Hospital, was cured of pancreatic cancer. I once saw the prescription this physician wrote, from the patient. This senior doctor was skilled in using the method of softening hardness and dispersing nodules (ruan jian san jie) to treat cancer. The size of his formulas was staggering—often dozens of herbs, in super-large doses—yet the efficacy was surprisingly good, winning unanimous praise from patients.

Now many colleagues in the medical world criticize the issue of large formulas, but from some of the cases I have followed up, there are no lack of good results obtained through large formulas. I have followed up another patient cured of nasopharyngeal carcinoma by pure TCM treatment; the TCM physician the patient consulted also used a surprisingly large formula, requiring an extra-large medicine pot to decoct it, yet the patient's cancer was cured. Such real efficacy is often more meaningful than theoretical controversy.

The late renowned Shanghai TCM professor Qiu Peiran once mentioned the unique therapeutic method of "large-formula compound treatment," noting its clinical value in treating difficult and complicated diseases. The late anti-cancer master Liang Xiuqing was also accustomed to using large formulas when treating cancer, often putting fifty or sixty herbs together.

I myself once treated a patient with a huge liver tumor who had already lost the opportunity for surgery. After choosing TCM treatment, I prescribed a large formula of more than sixty herbs. By the fourteenth month of treatment, the patient's tumor had shrunk by 2 cm. Later the patient, hoping to speed up treatment, underwent interventional therapy, after which a series of side effects appeared and he died despite treatment.

So I believe that, before we have found a definite countermeasure against tumors, we should not over-criticize large formulas and heavy dosages. We should respect the efficacy of facts rather than cling rigidly to theory.

Of course, we cannot rule out that some TCM physicians have indeed achieved some successful results in treating tumors with conventional doses and small formulas. I once saw the late physician Kong Sibo, using fewer than ten herbs, each at only 6–10 g, sustain a late-stage intestinal cancer patient for more than six years. Such a light-dose, small-formula regimen not only reduced the patient's physical burden but also the financial burden on the family. But such successful cases are not common.

When physicians prescribe large formulas and heavy dosages, they must watch the risks. When using heavy dosages and large formulas, I myself generally have the patient first divide one dose into two or three days' taking; if there are no severe side effects, I gradually advance to one dose a day, so the patient's body can bear it. With heavy dosages and the large-formula approach, side effects are unavoidable. When prescribing, the physician is best able to warn about side effects, informing the patient and family; it is best also to explain to the patient himself the reason for such medication, so that when side effects appear, the patient and family will not be overly panicked.