Stubborn Diseases Demand Strong Medicines: On High-Dosing in TCM Cancer Treatment
After years of exploration, I have worked out some effective methods in treating tumors with TCM. One very important lesson is: using supernormal doses. Modern research also shows that certain TCM formulas or single herbs with anti-tumor effects act against tumors only when the blood drug concentration reaches a certain level; when the concentration is insufficient, no anti-tumor effect is achieved. Therefore, in treating cancer with TCM, supernormal dosing is almost unavoidable. But supernormal dosing brings a series of safety problems; clinical medication must be cautious, and improper handling can cause medical accidents. Most clinical TCM physicians hesitate precisely because they fear causing medical accidents, which in the end leads to poor clinical efficacy—thereby losing the forest for the trees.
The Qing-dynasty physician Wang Ruogu once said that there is no abscess or ulcer that cannot be cured. As a physician specializing in sores and ulcers, Wang Ruogu treated a large number of benign and malignant tumors over his career; his hallmark was large dosages, with some herbs used at three to four times the dose of modern TCM physicians. In recent years, my rapid and clear tumor-treatment outcomes are also related to my bold use of large doses once the pattern differentiation is accurate. When the dose is magnified to three to four times the conventional amount, the patient's tumor shrinks rapidly—even faster than with Western chemotherapy—and the general condition improves markedly. Some patients have survived for years under my treatment and now still live and work like normal people. Before coming to me, these patients had sought doctors everywhere, been treated by renowned TCM and Western experts in Beijing and Shanghai without effect, and been told their lives were nearing an end. My treatment plan is sometimes almost identical to what previous TCM physicians prescribed, but merely by adjusting the dosage and the method of administration, the efficacy is vastly different.
My total daily dosage is actually not greater than that of other TCM physicians. One characteristic of my prescribing is this: herbs that other doctors tell the patient to take in 2–4 divided doses, I have the patient take in one single dose. Other TCM physicians tell patients to take medicine 2–3 times a day; for the same herb I require only once daily. I basically also require the patient to rest for two days after every five days of medication, or to stop for one week after taking medicine for one week. Thus the patient's total drug load is not rising but falling. Yet with each dose the blood drug concentration is higher than under other doctors, so each dose genuinely exerts a therapeutic effect. A tumor is a chronically developing disease; one effective treatment per day is enough. If effective treatment runs for five to seven days and then medication is paused for a few days to let the patient's organs rest, it is no problem.
But such a dosing method has strong side effects. Today's patients have taken the too-sweet “peace-preserving” TCM formulas for so long that they have formed an ingrained mindset: they expect a TCM prescription to relieve symptoms rather than produce side effects. Therefore, when receiving a patient, the physician should, at the very first encounter, explain the side effects that may occur. It is better to describe the side effects as more serious than they actually may be than to omit them. Because when a patient taking medicine hits a side effect without warning, he becomes doubtful and frightened; but when the physician has explained in advance, the patient cooperates much better. I often tell patients that my formulas are not for general conditioning but for treating tumors, so taking them will entail considerable discomfort; when taking my formulas they must change their past mental set about TCM.
A drug without side effects is unlikely to have efficacy. As the ancients said: “If the medicine does not cause a dizzying, mirror-like reaction, the stubborn disease will not be cured.” Deep-seated, fatal illnesses demand strong medicines, and strong medicines inevitably have side effects. The discomfort of medication is not fatal, but rampant tumor progression certainly is. So long as the patient is clearly informed, most patients will understand, accept, and cooperate. After all, however severe the side effects of Chinese medicine, they are not as severe as those of Western chemotherapy.
When using strong medicines, another point to note is that the medication must be focused and refined, not sprawling. As long as pattern differentiation is accurate, direct the herbs in a single direction for the patient; do not throw in every kind of herb to mitigate the various comorbidities or side effects that may appear during dosing. Because once there are too many drugs, some of their mutual effects cancel out, and once canceled, the efficacy is greatly reduced. The tumor physician's focus is on treating the tumor; the patient's other underlying diseases can be addressed later, after the tumor is controlled.
Supernormal dosing must be done cautiously and safely. I generally use a gradual escalation method to avoid accidents: after the patient has taken a lower dose without violent side effects, I gradually increase it to the supernormal dose. Such a dosing method is safe and reliable, with no need to worry about medical accidents. I have treated many cancer patients, and not a single safety incident due to excessive dosage has occurred to date.