Should Cancer Patients Use Traditional Chinese Medicine as an Adjunct During Radiotherapy and Chemotherapy?

Family members of cancer patients often ask me whether they should use traditional Chinese medicine (TCM) as an adjunct during radiotherapy and chemotherapy. Their attending Western-medicine oncologists tell them, in very certain terms, that they should not, and even forbid them from using any TCM support. To this I can only say that Western-medical education in our country has gone seriously off track, with far too much discrimination against TCM. The state has of course recognized this problem and in recent years has been vigorously supporting the development of TCM.

For cancer patients undergoing radiotherapy and chemotherapy, using TCM as an adjunct does more good than harm—provided, of course, that they find a TCM physician who specializes in cancer and who understands the common side effects of radiotherapy and chemotherapy and how to manage them. Many cancer patients are only referred by their attending Western doctors to seek help from a TCM physician when they can no longer tolerate chemo or radiotherapy. But the TCM physicians these patients usually find lack experience in handling the side effects of cancer treatment, so they rarely receive effective help.

We must acknowledge that specialization matters. Medicine is a skilled trade, and repeated training in one field certainly raises a doctor's competence in dealing with that category of disease. I strongly oppose the idea that a TCM physician is a generalist hospital in one person: a TCM doctor who treats every kind of illness may end up being only mediocre at all of them, because human energy is finite and no physician can have deep expertise in every disease. Life is no trivial matter. A physician who treats diseases he does not understand by wordplay violates the Heaven's virtue of cherishing life. Physicians should humbly recognize the limits of their time and energy: with serious illnesses, either stay out of them or devote yourself to one field and raise your skill as high as you can—only thus can you avoid doing harm.

Where conditions allow, when a patient decides on integrated Chinese-Western treatment for cancer, he should first choose a specialty hospital that treats cancer with integrated Chinese-Western medicine—such as Guang'anmen Hospital and Wangjing Hospital in Beijing, or Longhua Hospital in Shanghai—whose physician teams have rich clinical experience in integrated cancer care. The next best option is to seek a TCM physician who has long studied cancer and does not reject Western medicine.

I have written many articles on TCM support during chemo and radiotherapy; interested readers can search my earlier posts. Among them, the one easiest for lay readers to understand is My Self-Formulated Jianwei Shengxue Decoction for Supporting Cancer Patients During Chemotherapy and Radiotherapy. That article was written more than two years ago and summarized my clinical experience at the time in supporting cancer patients through chemo and radiotherapy; click the title link to read it. I have gained some new insights in this area over the past two years and will write a dedicated article when I have time, but for most cancer patients, using my Jianwei Shengxue Decoction as an adjunct still offers some benefit.

In practice, some cancer patients do have mild side effects during chemo and radiotherapy, but far more find the side effects unbearable. Recently I saw a cancer patient from Shenyang who developed severe spasmodic pain after chemotherapy; the hospital tried every method but could not relieve it. Now, let alone undergo chemo, just hearing the word "chemotherapy" triggers a conditioned spasmodic pain response. This patient is a researcher who initially favored modern medicine; now he would rather die than accept Western treatment. Although the chemo shrank his tumor, the excruciating side effects made life worse than death. Most clinicians cannot personally experience such suffering, so their habit of making medical decisions for patients purely by following guidelines contradicts the spirit of evidence-based medicine. I believe such Western doctors should go back to medical school and relearn evidence-based medicine—this is not TCM content; it is the very Western medicine they were taught, but they failed to master it.

TCM's pattern differentiation and treatment (bianzheng lunzhi) has many advantages in symptomatic care and can markedly relieve the various side effects of chemo and radiotherapy. The spasmodic pain described above is something I encounter often; I have used Shaoyao Gancao Tang (White Peony 3–6 g, Licorice 3–6 g, steeped in boiling water and drunk as a tea) to resolve spasmodic pain and inability to walk in several patients after chemo or radiotherapy. After receiving this TCM support, these patients' suffering eased and they completed their treatment smoothly—what is wrong with that? Must things end like the Shenyang patient, abandoning an effective treatment only because the side effects were too severe? The depth of bias many Western clinicians hold against TCM only proves how shallow their own learning is, nothing more.

Many leading Western oncology experts in China are also strongly calling for integrated Chinese-Western treatment of cancer—Academicians Ji Jiafu and Sun Yan, among others. These are towering figures in Chinese oncology, internationally renowned specialists, and they support patients choosing integrated treatment rather than Western medicine alone. The Western doctors opposing integration whom most patients and families encounter—with all respect—are far too junior in their medical attainments to hold a candle to these academicians.

If you worry that taking Chinese and Western medicines together overburdens the liver, you can simply give the patient preventive hepatoprotective treatment during the course, such as ademetionine (Attomoran) and other liver-protective drugs. Speaking of liver protection, the situation is deeply regrettable. In recent years I have attached great importance to protecting patients' liver function, yet I have seen many oncology physicians only address liver damage after it appears, taking no preventive measures beforehand—so that many patients' liver function is damaged during treatment.

Although preventing liver damage cannot guarantee it one hundred percent, failing to prevent it means a considerable number of patients will eventually be unable to continue integrated treatment and must stop. Some patients ultimately die not from cancer itself but from treatment interrupted due to liver damage. It is worth noting that the great majority of patients I have seen with liver damage were not taking any Chinese medicine, so drug-induced liver injury from TCM can be ruled out in their cases.

We often ask what proportion of drug-induced liver injury is caused by Chinese medicines, but have we asked what causes the rest? Apart from TCM, it must be Western drugs. Why selectively turn a blind eye to Western-drug-induced liver injury while fixating on the problem with Chinese medicines? The rational approach is not to criticize the hepatotoxicity of either; every medicine has some toxicity, and when a patient falls ill and has no medicine to take, he may die. What we should do is not denounce drug hepatotoxicity but prevent drug-induced liver injury from occurring.

This article is somewhat sharp in tone, against my usual habit of avoiding controversy, but when it comes to such a fatal medical prejudice, only sharp language is enough to refute the fallacies. Medical prejudice affects the life span of countless patients; those who study medicine cannot stand by and watch.