TCM Treatment Principles for Cancer Patients with High VEGF Expression
VEGF (vascular endothelial growth factor) is an important tumor marker. In many patients' test reports, VEGF expression is found to be excessively high. VEGF is a pro-angiogenic factor with multiple physiological functions; it promotes wound healing, tissue and organ repair, embryonic development, and angiogenesis. It is rarely present in normal tissues but is abnormally elevated under pathological conditions such as ischemia, inflammation, and tumors. Therefore, testing VEGF can assist in the diagnosis of the above diseases.
Excessively high VEGF expression in tumor patients generally indicates a poor prognosis. VEGF is an independent adverse prognostic factor for disease-free survival and overall survival in cancer patients. In breast cancer patients, VEGF is associated with tumor size, receptor negativity, mutant p53, and poor tumor differentiation. While inhibiting endothelial cell apoptosis, VEGF can also inhibit breast cancer cell apoptosis, reducing the effectiveness of endocrine therapy and chemotherapy.
VEGF is not entirely without merit; it also points the way to cancer treatment. Anti-angiogenic therapy is an effective treatment targeting VEGF. Tumor growth depends on blood supply for nutrients, and VEGF plays an important role in the growth of new blood vessels. Therefore, inhibiting VEGF can suppress tumor angiogenesis, slow tumor progression, and prolong patient survival. This is the theoretical basis for anti-angiogenic drugs such as bevacizumab in treating tumors.
Many Chinese medicinal herbs (or formulas) have effects similar to bevacizumab, such as Xihuang Pills, chuanxiong (Ligusticum rhizome), and ezhu (Curcuma zedoaria). They can also inhibit tumor angiogenesis, and the inhibitory effect is positively correlated with dosage. In TCM, these herbs belong to the category of blood-activating and stasis-resolving herbs or blood-breaking and stasis-expelling herbs.
Traditional TCM has many methods for determining whether a patient has a blood-stasis constitution and thereby deciding whether to use blood-activating and stasis-resolving treatment. However, the diagnostic accuracy of traditional TCM is not as good as modern medical detection methods. We can combine Western diagnosis with TCM treatment, using formulas dominated by blood-activating and stasis-resolving herbs for patients with high VEGF expression.
Of course, high VEGF expression is not only related to tumors; it is also associated with inflammation, ischemia, and diabetes. VEGF can promote the aggregation of inflammatory cells; when tissues are hypoxic, VEGF gene expression may also be upregulated to induce angiogenesis and improve ischemic symptoms. Inflammation, ischemia, and diabetes often act together with tumors to cause excessively high VEGF expression. Some tumor patients may simultaneously have diabetes, ischemia, and inflammation; medication for these patients must take all these factors into account.
Whether in TCM or Western medicine, clinical medication requires objective indications. The clearer the diagnosis, the more targeted the medication, the more reliable the efficacy, the smaller the side effects, the lower the risk for both patient and doctor, and the greater the therapeutic benefit. Therefore, TCM physicians should not reject modern detection methods but should learn relevant knowledge, understand the principles behind tumor markers like VEGF, and keep pace with the times rather than rigidly adhering to old rules. This is greatly beneficial for improving the efficacy of TCM cancer treatment.