Several Solutions to Excessive Sweating in Cancer Patients
In clinical practice, I have found that some cancer patients suffer from excessive sweating. I have tried several methods with modest success, and so I write this article to recommend, for your reference, the antiperspirant herbs and formulas I commonly use.
Yupingfeng Granules
The patent medicine Yupingfeng Granules derives from an ancient TCM formula, "Yupingfeng San" (Jade Screen Powder). Yupingfeng San consists of three herbs: raw Huangqi (Astragali Radix), Fangfeng (Saposhnikoviae Radix), and Baizhu (Atractylodis Macrocephalae Rhizoma). Its action is to boost qi, secure the exterior, and stop sweating; it is used for deficiency of the exterior with insecurity, spontaneous sweating with aversion to wind, a pale-white complexion, or a frail physique prone to contracting wind evils.
Yupingfeng San is the representative formula for supporting the righteous and securing the exterior to stop sweating; it is the most commonly used antiperspirant Chinese medicine in the clinic and is especially suitable for frail cancer patients.
Generally, patients with mid- to late-stage cancer are, due to the consumption by the tumor, relatively weak, with obvious aversion to cold and wind-they cannot stand being in an air-conditioned room for long, yet they sweat easily, and once they sweat they readily catch colds or develop rhinitis symptoms. Such patients are very well suited to Yupingfeng San.
The patent medicine Yupingfeng Granules is also economical and convenient. Several manufacturers produce it, and in most places it is a medical-insurance-covered drug.
Modified Danzhuru Tang
Danzhuru Tang (Bamboo Shavings Decoction) is a formula TCM commonly uses for "zang zao" (hysteria in women). In clinical practice I have found it effective against a variety of symptoms caused by autonomic nervous system dysfunction.
Traditional TCM holds that Danzhuru Tang nourishes the heart and quiets the spirit, clears the heart, and eliminates vexation. It mainly treats heart-vacuity vexation and oppression, headache and shortness of breath, unresolved internal heat, oppression and turmoil in the chest, as well as postpartum heart-vacuity palpitations, vexation approaching despair, and zang zao with incessant sorrow.
But in fact this formula can also be used to treat emotional tension and excessive sweating in cancer patients, especially those who break into a sweat whenever tense. For such patients, using Danzhuru Tang can simultaneously relieve emotional tension and persistent sweating. If Fuxiaomai (Tritici Levis Fructus), which has an antiperspirant action, is added to the base formula, the effect is even better.
The formula is as follows:
Maidong (Ophiopogonis Radix) 15 g, Huaixiaomai (Huai wheat) 30 g, Fuxiaomai (Tritici Levis Fructus) 30 g, Zhi Gancao (prepared Glycyrrhizae Radix) 10 g, Dangshen (Codonopsis Radix) 15 g, Fuling (Poria) 15 g, Fabanxia (processed Pinelliae Rhizoma) 10 g, Danzhuru (Bambusae Caulis in Taeniam) 10 g, Shengjiang (Zingiberis Rhizoma Recens) 7 slices, Dazao (Jujubae Fructus) 3-5 pieces.
The Huaixiaomai here is a medicinal herb that many pharmacies do not carry; you can buy it online. Huaixiaomai differs from the Fuxiaomai sold in pharmacies: Fuxiaomai is unripe wheat that floats on water-hence its name "floating wheat"-and its main action is to stop sweating. Huaixiaomai, by contrast, is ripe wheat produced in the Huai River basin, whose main action is to nourish the heart and quiet the spirit.
I myself often use this formula to treat depression (especially postpartum depression), and it has a certain efficacy. TCM formulas have always been multi-purpose; in TCM, as long as the disease mechanism is the same, no matter what symptoms appear, the same approach can be used to treat them-this is called "treating different diseases with the same method."
Sanren Tang and Guizhi Tang
The ancients had a saying: "If sweating does not resolve [the condition], it is either wind or dampness." This means that after using an exterior-releasing, sweat-promoting herb for a heat pattern, sweat appears but the patient's heat is not resolved, and the patient still sweats and has fever. Then there are only two possibilities: one is "Taiyang wind-stroke," the other is internal damp-heat. Persistent spontaneous sweating after Taiyang wind-stroke can be resolved with Guizhi Tang; persistent sweating from internal damp-heat can be resolved with Sanren Tang.
Prof. Yin Huihe once proposed that TCM treatment should emphasize "grasping the main pattern"-that is, grasping the principal contradiction, without requiring every secondary symptom to be present before deciding on a formula. The main pattern of "sweating that does not resolve" is sweat; there need not be obvious "heat." So for a patient with persistent sweating, as long as we can determine which "pattern" it is, we can still use Guizhi Tang and Sanren Tang according to TCM's pattern differentiation and treatment.
Patients whose persistent spontaneous sweating is treated with Guizhi Tang are characterized by aversion to cold and wind. "Taiyang wind-stroke" means wind attacking the Taiyang channel. The Taiyang channel governs the exterior of the whole body and has the function of defending outward. After a Taiyang wind-stroke, the patient's righteous qi loses its outward-defending ability. Then Guizhi Tang is used to harmonize the ying and wei and boost the outward-defending yang qi. Once the defensive yang qi is secure, sweating stops.
Guizhi Tang formula:
Guizhi (Cinnamomi Ramulus) 10 g, Baishao (Paeoniae Radix Alba) 10 g, Zhi Gancao (prepared Glycyrrhizae Radix) 6 g, Dazao (Jujubae Fructus) 5 pieces, Shengjiang (Zingiberis Rhizoma Recens) 5 slices.
So what are the characteristics of damp-heat? TCM holds that damp-heat is dampness combined with heat; such patients generally have sticky, sluggish stools, irritability, afternoon fever, or a sensation of heat in the five centers (palms, soles, and chest). For such patients, one must remove dampness to clear heat and stop sweating.
TCM holds that when dampness and heat are mixed together, like oil and flour, they are hard to separate; one must remove the firewood from under the pot-eliminate the dampness-to dispel the patient's heat. The representative formula for clearing damp-heat is Sanren Tang; of course, some say Yinchen Wuling San also works well, but I personally prefer Sanren Tang and use it more often. I append both Sanren Tang and Yinchen Wuling San for readers' reference.
Sanren Tang formula:
Xingren (Armeniacae Semen) 6 g, Yiyiren (Coicis Semen) 30 g, Baikouren (Amomi Rotundus Fructus) 6 g, Fuling (Poria) 15 g, Fabanxia (processed Pinelliae Rhizoma) 10 g, Danzhuru (Bambusae Caulis in Taeniam) 10 g, Shengjiang (Zingiberis Rhizoma Recens) 7 slices, Tongcao (Tetrapanacis Medulla) 6 g, Houpo (Magnoliae Officinalis Cortex) 6 g, Huashi (Talcum) 15 g (wrapped for decoction), Zhuye (Phyllostachys Folium) 3 g.
Yinchen Wuling San formula:
Yinchen (Artemisiae Scopariae Herba) 15 g, Guizhi (Cinnamomi Ramulus) 10 g, Baizhu (Atractylodis Macrocephalae Rhizoma) 10 g, Zexie (Alismatis Rhizoma) 10 g, Fuling (Poria) 10 g, Zhuling (Polyporus) 10 g.
Liuwei Dihuang Wan
Liuwei Dihuang Wan (Rehmannia Six-Ingredient Pill) is mainly used for patients with yin-deficiency night sweating, most often pediatric patients. Night sweating means sweating during sleep and stopping on waking; such yin-deficiency night sweating can be treated with the patent medicine Liuwei Dihuang Wan, produced by many manufacturers.
If a patient has two or more patterns simultaneously, the above approaches may be used in combination-for example, Guizhi Tang combined with Yupingfeng, or Sanren Tang combined with Danzhuru Tang, and so on.
Of course, there are many more TCM approaches to sweating patterns, and many doctors have their own preferences. The above are my personal prescribing preferences, and in actual clinical practice they have indeed solved the problem for some patients. There remain some patients whom these formulas cannot help, and they will need a doctor to prescribe based on their own condition. This article risks generalizing from a single point and serves only for your reference.