Exploring the TCM Purgative (Gongxia) Method for Treating Cancer

Malignant tumors growing in the chest cavity, abdominal cavity, and pelvic cavity should be treated first with the purgative (gongxia) method.

Today's patients are soft and spoiled; they rejoice at tonics and fear warming attack. Worse, various so-called leading experts in TCM blindly emphasize supporting vital qi, preaching the heresy that raising a patient's immunity alone is enough to fight cancer. Nothing misleads people more than this. It is also a marketing gimmick by sellers of health supplements and various TCM tonic products, and over-promotion has created a society-wide illusion.

Cancer cells are quite intelligent: they can evade the surveillance of the human immune system and even attack it, paralyzing it so it cannot work normally. The claim that cancer can be treated with tonics, further cited as proof of European and American research on immunity killing cancer cells (in fact these are all baseless nonsense), is pure deception.

Cancer treatment certainly requires combining vital-qi support with pathogen expulsion, but the key lies in expelling the pathogen. Supporting qi can only raise the patient's ability to resist complications and modestly extend life by a few months to a year or two, and even this is extremely hard to achieve, because tumor growth simply gives no breathing room.

Most clinical TCM doctors fear responsibility and love prescribing harmless "peace formulas" to patients. Peace formulas, by improving the constitution, can certainly create the illusion of great efficacy, but the effect is hard to sustain. Patients are especially easy to fool: short-term results are enough to kindle limitless hope, leading them to mistake the therapy for effective, until they miss the best window for purgative attack. By the time the disease is severe beyond rescue, using the purgative method offers no chance left.

I used to think cancer treatment must show results slowly, but now I have completely changed my mind. If cancer is treated by the purgative method, results are rapid and obvious; though one may not win the war quickly, one can certainly win quick, decisive battles. If cancer treatment drags on, the great majority of patients develop one complication after another; even if they do not die of the cancer itself, they cannot escape complications. Malignant tumors in the chest, abdomen, and pelvis, in particular, respond very markedly to purgative treatment.

Tumors of the chest, abdomen, and pelvis were anciently grouped as accumulations (ji ju): cold accumulation, heat accumulation, food accumulation, phlegm accumulation, blood accumulation, flesh accumulation, qi accumulation, and so on. Through examination and inquiry, carefully identifying which kind of accumulation the patient has makes treatment far more targeted.

There are four key points in using the purgative method for cancer.

First, distinguish whether the patient is heat or cold, or mixed cold-heat, or neither.

Heat-pattern patients are attacked with cold, cold-pattern patients with heat. For mixed cold-heat or neither-cold-nor-heat patterns, since classifying them is difficult, do not force a category; you may skip cold-heat differentiation, use herbs with no cold-heat bias, and directly combine spleen-fortification, phlegm-resolving and nodule-scattering, blood-activating and stasis-resolving, and purgative methods to directly attack the accumulation, quickly disperse the tumor, scour away the filth, and leave no evil behind.

Whether the accumulation is cold, heat, or neither, phlegm-resolving and nodule-scattering is indispensable. Use many kinds of such herbs in generous doses, unconstrained by the number of ingredients in ancient classical formulas. Combining several phlegm-resolving nodules-scattering herbs increases efficacy while reducing the downside of very large doses of a single herb. At large doses side effects are inevitable; the effective dose of a single herb is often very close to the lethal dose, and the margin is hard to manage. Combining several herbs avoids this risk well.

Blood-activating and stasis-resolving must be tailored: if the patient has stasis, use stasis-resolving herbs; if not, do not. Especially in bleeding tumor patients—such as leukemia patients, or terminal cancer patients with thrombocytopenia and even purpura—do not recklessly use blood-activating stasis-resolving herbs; at such times treatment should center on cooling blood and dispersing stasis.

Second, gauge the strength of the purgative.

Gauging purgative strength is very hard: too strong and the patient cannot bear it; too weak and there is no effect. Clinical dosing must be cautious: start small, increase if ineffective, and gradually raise the dose until it works. TCM has accumulated very valuable experience here: ancients treating chest and abdominal tumors with pills like Xiben Wan, Yinyang Gongji Wan, and Feigi Wan often used a micro-dose escalation method, starting from the smallest dose (one paulownia-seed-sized pill), gradually increasing until the patient developed loose stools, then returning to the minimum and escalating again to loose stools, repeating the cycle. This is a very cautious method that expels pathogen without harming healthy qi.

But in practice it should not be copied rigidly. If the patient is robust and the tumor rampant, one may well give a vigorous scourging over a short period to rapidly remove the tumor's great oppression of the body, then reduce to a safe dose.

When I previously treated a case of a huge pelvic tumor, I used Dahuang (Rheum) up to 30 g; later, reviewing the case record myself, I felt frightened. But the patient was robust: after three packages there was painful diarrhea for three days, and all symptoms settled. This patient had gone home from Xiangya Hospital bedridden, waiting to die. Two weeks later the tumor rapidly softened and shrank—an effect like bringing the dying back—with no danger.

Third, dose according to the patient's strength.

The purgative method works not only in robust patients; in weak patients, properly used, it works just as rapidly. But the timing and measure of attack and support must be well judged. When the patient is weak, combine attack and support: vigorously tonify and lightly attack, or evenly tonify and evenly attack, or tonify first then attack. But do not, because the patient is weak, hesitate and dare not purge. Remember: cancer patients are weak because of disease, not diseased because of weakness; if the tumor is not removed, mere tonification may briefly relieve the deficiency but ultimately cannot prevent the end.

For a cancer patient, treatment at any moment is more favorable than treatment a moment later; purging early is far better than purging late. A doctor who hesitates and dares not purge causes the patient to miss the therapeutic window.

Fourth, remember the contraindications of the purgative method.

In brief, the contraindications are: use cautiously when the patient's stomach qi is failing with spleen deficiency, loose stools, even diarrhea; use cautiously when the patient has an exterior pattern such as fever or superficial pain; use cautiously when the patient is in the agonal stage.

If you purge a patient with failing stomach qi and spleen deficiency, the spleen will collapse further and become irrecoverable. If you purge a patient with an exterior pattern, the exterior pattern will penetrate inward; exterior heat congealed internally risks causing chest-binding (jiexiong) and pleural/peritoneal effusion. In such patients, resolve the exterior first; once the exterior is gone, you may attack the interior. Or resolve both interior and exterior at once, using purgation and exterior-releasing together, but this requires a very solid doctor. If not confident, be cautious: resolve the exterior first, then attack the interior.

Once a patient is in the agonal stage, skin and bones, especially after modern medicine has repeatedly pulled him back so that every organ is actually in failure, it is too late for purgation. At such a time the doctor should be doubly cautious; from both the patient's safety and the doctor's career perspective, purgation should not be used lightly.