TCM Case: Ms. Wang with Recurrent Ovarian Cancer and Multiple Metastases

Ms. Wang, female, a resident of Meihekou City, 55 years old. She had suffered from ovarian cancer for many years and, despite treatment from many quarters, it recurred in recent years. Referred by a fellow patient, she sought TCM treatment from the author; first visit December 7, 2015. On palpation, an egg-sized tumor could be felt at the junction of the groin and lower abdomen. Because of tumor compression, the right leg was severely swollen, recently spreading to the ankle, with dull discomfort at the ankle. On the left side, the cun, guan, and chi positions were all deep, thin, and weak; the right pulse was wiry, rapid, and forceful. The tongue coating was pale white with teeth marks along the edges. Because the patient had had intestinal surgery with an anastomosis device, intestinal distension was marked, defecation was poor, and bowel movements were frequent; blood pressure was high; sleep had recently been poor, though previously good. A metastatic tumor at the clavicle was visible to the naked eye. There was no tenesmus during defecation. She used to be cold-intolerant, but after chemotherapy she was no longer; she occasionally felt dizzy. CA125 was elevated.

Considering that the wiry, rapid right pulse was normal given compression by the right-sided tumor, the author judged the patient's constitution from the left pulse. The post-chemotherapy change in constitution did not affect the judgment of the original cause of illness. Combining the patient's account with the tongue and pulse, the author considered the tumor a yin-pattern, deficiency-type condition. The prescription was drafted as follows:

Shudi (Rehmanniae Radix Praeparata) 40 g, Lujiaojiao (Cervi Cornus Colla) 12 g (melted separately), Baijiezi (Sinapis Semen) 8 g, Mahuang (Ephedrae Herba) 2 g, Paojiang (Zingiberis Rhizoma Praeparatum) 2 g, Sheng Gancao (Glycyrrhizae Radix) 4 g, Rougui (Cinnamomi Cortex) 4 g (ground, swallowed in suspension), Fabanxia (Pinelliae Rhizoma Praeparatum) 10 g, Fuling (Poria) 10 g, Jiangcan (Bombyx Batryticatus) 10 g, Juemingzi (Cassiae Semen) 15 g (added later), Shancigu (Cremastrae Pseudobulbus) 10 g, Huangyaozi (Dioscoreae Bulbiferae Rhizoma) 10 g, Houpo (Magnoliae Cortex) 10 g, Cangzhu (Atractylodis Rhizoma) 10 g, Zexie (Alismatis Rhizoma) 10 g

One dose daily, taken all at once after breakfast.

Every night at bedtime, take Xihuang Wan with warm yellow wine: 6 g on day 1, 9 g on day 2, and 12 g from day 3 to day 7.

On December 23, in the early stage of taking the above formula, the ankle swelling resolved and chest oppression disappeared in the first week, but relapsed when the medicine was stopped. She took Jinkui Shenqi Wan; after taking it, urine output instead decreased, the leg swelled again, and the face became puffy. She also had sweating and palpitations.

Shudi 40 g, Lujiaojiao 12 g (melted separately), Baijiezi 8 g, Mahuang 2 g, Paojiang 2 g, Sheng Gancao 4 g, Rougui 4 g (ground, swallowed in suspension), Fabanxia 10 g, Fuling 10 g, Jiangcan 10 g, Juemingzi 15 g (added later), Houpo 10 g, Cangzhu 10 g, Zexie 10 g, Zhizi (Gardeniae Fructus) 10 g, Dangshen (Codonopsis Radix) 15 g, Maidong (Ophiopogonis Radix) 15 g, Wuweizi (Schisandrae Fructus) 15 g, Tengligen (Actinidiae Radicis) 30 g, Shiwei (Pyrrosiae Folium) 20 g