An Outline of Shen Shaogong's Approach to Treating Malignant Tumors

Professor Shen Shaogong was the 19th-generation inheritor of the renowned TCM "Shen family gynecology"; his ancestor Shen Yaofeng's Shenshi Nüke Jiyao is a classic of TCM gynecology. The Shen family had practiced medicine for generations and accumulated rich clinical experience. Professor Shen worked in teaching, research and clinical practice at the China Academy of Chinese Medical Sciences for over 40 years, serving as director of the emergency department and deputy director of the basic-research institute. He had rich clinical experience and a solid theoretical grounding. His approach to treating tumors can be summarized as follows.

First, emphasis on supporting healthy qi. Although TCM has two broad strategies - supporting healthy qi and expelling pathogen - in treating tumors, the Shen family placed particular emphasis on supporting healthy qi. He advocated that tumor treatment should take supporting healthy qi as the root and pattern differentiation as the guide. These are his two most basic principles of tumor treatment, reflecting a steady clinical style. Especially today, when tumor patients generally first undergo Western treatment and, by the time they seek TCM, are not only in the middle-to-late stage but have already been through surgery, radiotherapy and chemotherapy, with healthy qi severely damaged, it is inevitable to emphasize supporting healthy qi.

Second, taking the pattern as primary, dividing tumor patients' patterns into several units and combining formulas. The Shen family stressed that tumor treatment should be led by "pattern differentiation and treatment"; even when using disease-targeted medications, they should still be applied under the principle of pattern differentiation. Otherwise, treating disease solely according to modern pharmacological anti-tumor reasoning does not easily yield good results.

The Shen family divided cancer patients' patterns into several units, as follows:

1. Phlegm-turbidity obstruction: symptoms include heavy head and chest oppression, sticky mouth and poor appetite, a greasy tongue coating and a slippery pulse. Among these, the greasy coating is especially key; as long as a greasy coating is seen, the pattern can be definitively differentiated as phlegm-turbidity obstruction. For such patients, the Shen family uses a modified Wendan Tang, with herbs such as Zhuru (Bambusae Caulis in Taeniam), Zhiqiao (Aurantii Fructus), Fuling, Chenpi, Shichangpu (Acori Tatarinowii Rhizoma) and Yujin (Curcumae Radix), six herbs in all, to treat phlegm-turbidity transforming into heat.

2. Stasis-toxin accumulation: symptoms include stabbing pain, a purple-dark tongue with ecchymoses, and a choppy, wiry, tight pulse. For this type, the Shen family often uses Xuefu Zhuyu Tang as the base formula unit: for mild stasis-toxin use Danshen, Mudanpi and Chishao; for severe use Taoren and Honghua; to move qi and open the chest use Chaihu, Zhiqiao and Jiegeng; to lead blood downward use Chuanniuxi; to harmonize and nourish blood use Shengdi and Danggui, so as to invigorate blood without injuring it, and resolve stasis while engendering new blood. To master the treatment of stasis-toxin accumulation more skillfully, I recommend further reading Wang Qingren's Yilin Gaicuo, because the Shen family's treatment of this pattern basically uses the formulas from that book.

3. Insufficiency of kidney essence: symptoms include soreness and weakness of the lower back and knees, a thin non-greasy coating, and a deep, fine pulse. For such patients, the Shen family often uses Qiju Dihuang Tang as the base unit, with main herbs including Gouqizi, Yejuhua (wild Chrysanthemi Flos), Shengdi, Huangjing (Polygonati Rhizoma), Sheng Duzhong (Eucommiae Cortex) and Sangjisheng (Taxilli Herba). The first four nourish yin and clear the liver; the last two supplement both yin and yang.

4. Spleen-qi deficiency: symptoms include poor appetite and loose stools, lassitude and fatigue, a pale tongue with white coating, and a moderate, weak pulse. For such patients, the Shen family often uses Xiangsha Liujunzi Tang as the main formula, with herbs: Dangshen, Chao Baizhu, Fuling, Chenpi, Muxiang (Aucklandiae Radix), Sharen, Shichangpu, Yujin, Sheng Duzhong and Lugen (Phragmitis Rhizoma). On the basis of the traditional Xiangsha Liujunzi Tang, the Shen family added Shichangpu and Yujin mainly for their penetrating, moving and dissipating action, so that the Six-Gentlemen formula supplements without stagnating; moreover, Shichangpu and Yujin can adjust the cerebral cortex and stabilize tumor patients' emotions. Duzhong gently warms kidney yang, and Lugen engenders fluids and nourishes spleen yin, thereby nourishing yin and boosting qi and preventing excessive warm-drying from damaging spleen yin.

5. Fluid and humoral damage: symptoms include constipation and thirst, a dry red tongue, and a thin, rapid pulse. For such patients, the Shen family mainly modifies Zengye Tang, with herbs such as Shengdi, Maimendong and Xuanshen (Scrophulariae Radix).

A single patient may have more than one of these five patterns. The Shen family divided them into distinct units; based on the patient's clinical symptoms, one judges which unit or units the patient presents, and then combines the herbs accordingly.

The Shen family also had a universal formula for malignant tumors: Xianhecao 10 g, Sheng Yiyiren 10 g, Laifuzi (Raphani Semen) 10 g, Gualou (Trichosanthis Fructus) 30 g, Baihua Shegancao 30 g, Danshen 30 g. For different patients, the Shen family modified this universal formula using his unit-combination medication theory.

Another feature of the Shen family's approach to tumor patients is advocating light dosing: decoctions should be halved, and pills used as much as possible for slow treatment. This approach fits the reality of tumor patients well. Over the years I have seen many tumor patients die from overly heavy medication; not only do some doctors have a habit of recklessly using "tiger-and-wolf" herbs, but some patients, out of inner fear, also like to overuse and heavily dose various toxic anti-cancer herbs. Such medication is truly nine-deaths-one-life, mostly over-treatment, with the probability of failure far exceeding that of success.

The Shen family's medication logic is clear and operational, easy for beginners to learn, and counts as one of his features in treating malignant tumors. But in clinical practice, relying on this approach alone is probably far from enough to treat malignant tumors; we still need to master more TCM knowledge of treating malignant tumors to cope with the ever-changing clinical problems of oncology.