TCM's Understanding of the Causes of Cancer
TCM broadly divides the causes of human disease into three categories: internal causes, external causes, and causes that are neither internal nor external. This division already existed in early TCM classics such as the Huangdi Neijing and the Jinkui Yaolue; the Song dynasty physician Chen Wuze later summarized it systematically, and it became the general outline of TCM pattern differentiation and treatment.
The so-called internal causes are those arising from the patient's own constitution, including the seven emotions and six desires and the bodily endowment. External causes include natural factors such as wind, cold, dampness, dryness, and summer-heat, as well as contagion from major public-health events. Causes that are neither internal nor external belong to accidental events—for example, a person's leg being bitten by a dog, or a person suddenly falling and injuring himself. These are neither-internal-nor-external causes.
In broad terms, the causes of cancer (malignant tumors) fall into these same three categories. But on closer inspection they can be further divided. Among internal causes are qi stagnation, internal deficiency, and imbalance; among external causes are the "six excesses" (liu yin) and dietary disorder.
Neither-internal-nor-external causes include accidental injuries caused by particular living habits. For example, in rural northern China people warm themselves in winter by sleeping on a heated kang bed. Some people sleep on the kang so long that indentations appear on their bodies; these are a kind of scar. If a kang scar does not heal for a long time, it may eventually develop into a scar carcinoma. A special note here: many people have heard of common cancers such as liver, gastric, lung, and breast cancer, but few know there is also a scar carcinoma, caused by a long-unhealed scar on the body. Another example is exposure to nuclear radiation; these too are neither-internal-nor-external causes. Such causes are not common, so I pass over them briefly. This article mainly introduces the internal and external causes of cancer in TCM view.
Most cancers are not contracted in a single day; rather, some chronic disease gradually develops into cancer over a long period. For example, chronic hepatitis such as hepatitis B gradually develops into cirrhosis and liver cancer; chronic atrophic gastritis and gastric ulcers gradually develop into gastric cancer; chronic esophagitis and reflux esophagitis gradually develop into esophageal cancer; chronic prostatitis and bladder stones gradually develop into prostate and bladder cancer. Anywhere in the body except the hair and nails, chronic lesions, cumulative irritation, and inflammatory reactions can, over time, progress to cancer. Therefore, chronic-disease patients must take good care of their bodies. The current cancer prevalence is very high: about one in five people in rural areas and one in four in urban areas will eventually develop cancer. These cancer patients did not get cancer for no reason, all at once.
Ancient TCM, though lacking the various examination instruments of modern Western medicine, through generation after generation of physicians observing and summarizing the triggers of disease, discovered cancer patterns that still accord well with scientific principles. They also found that the cancerous transformation of the body is not the work of a single day. As the saying goes, ice three feet thick is not the result of one day's cold. The cancerous transformation of our bodies comes from our own habitual inattention. The reason we need to understand TCM's view of cancer causes is that these determine the approach we should take when treating cancer patients with TCM.
This article continues by introducing the specific content of the internal and external causes of cancerous transformation as TCM understands them.
First, the qi-stagnation doctrine among internal causes. TCM holds that changes in human emotion bring about changes in physiological function and produce disease. That is, a person's joy, anger, sorrow, and joy—the seven emotions and six desires—are important causes of disease. This is indeed so; modern Western medicine has likewise found that adverse human emotions are an important cause of chronic disease and even of cancer.
A person who is long depressed and downcast will not have a good stomach and intestines. We say that a person who thinks too much does not put on flesh, because such a person's overthinking damages the spleen, leading to spleen-stomach weakness, and they easily become patients with gastroenteritis. Although they eat fish and meat, they do not gain weight. Some depressed patients become emaciated; unless we solve their emotional problem, we can hardly solve their digestive-organ problem. Among patients with esophageal, gastric, and breast cancer, many have this kind of personality.
A person who flies into a rage at the slightest thing will not have a good cardiovascular or liver condition. TCM holds that anger injures the liver; indeed, many liver cancer patients are quick to anger. When I myself have been in contact with liver cancer patients, I have noticed this: they are especially prone to shifting their anger onto others, are critical of people, and are not tolerant or calm enough. A pessimistic person easily injures the lungs; long sighing and groaning is the best companion of lung disease.
I have further found that the family relationships of most cancer patients are tense, with family members lacking mutual tolerance and appreciation. Tense family relations keep a person's emotions in an adverse state, which greatly affects physical condition. In families whose members are generally long-lived, the family all get along. So when I give treatment advice to cancer patients, I first teach them to adjust their emotions and their family relationships, to make changes in cognition and behavior, and to change this important cancer-causing cause.
Modern medical research has also found that women with low-grade anxiety are more prone to breast cancer (by the way, breast cancer is not a woman-only disease; anxious men are also prone to it. Male breast cancer patients account for about one percent of all breast cancer patients, so few pay attention). Long-term disappointment tends to induce cervical cancer; an angry-eating and depressive personality easily leads to gastric and esophageal cancer. I once met an esophageal cancer patient whose elder brother had died of esophageal cancer twenty or thirty years before; at the time he had a nervous breakdown, and from then on his own esophagus always felt unwell. After he turned fifty, he himself developed esophageal cancer.
Therefore, when many TCM practitioners treat cancer, they first treat the patient's various qi stagnations. Some can be addressed with a little medication—adding herbs that regulate emotion such as Chaihu (Bupleurum), Yujin (Curcuma), or Meiguihua (Rose flower) to the formula. Some cannot be solved by medicine alone; at such times it is necessary to raise the patient's ideological awareness, to make the patient realize that his poor psychological state and mental depression are one of the important causes of cancer, and to remind him to adjust his emotions.
In this world there are a very few patients whose entire psychological state changes completely after cancer, and they recover without treatment. We often hear of someone who, after getting cancer, gave up everything in the past and went traveling around the world; when they came back from traveling the world, the cancer was gone. Such cases must exist. As far as I know, in China's cancer community there is someone called Lao Bu who has fought cancer this way; so far, without treatment, he has already lived seven or eight years. He is still out promoting his own approach to fighting cancer everywhere. Of course, not everyone is so lucky. I once knew someone called Fuchao Shanren who also hoped to cure his cancer through this natural approach, but he did not survive.
Adjusting one's emotions is certainly very helpful for cancer recovery, but relying solely on emotional adjustment to treat cancer is too risky; I do not recommend it. Moderate treatment is still very important.
Next, let me explain the concept of internal deficiency. The Huangdi Neijing says: "When healthy qi is preserved within, evil cannot invade." It also says: "Wind, rain, cold, and heat—if they do not encounter deficiency, evil alone cannot harm a person. Those who are suddenly caught in fierce wind and torrential rain yet do not fall ill are so because they have no deficiency; thus evil alone cannot harm them. This must be because the deficient evil wind meets with the person's bodily form; the two deficiencies combine, and then it attacks the form." This idea emphasizes that, besides external factors, a person's own constitutional deficiency is greatly related to falling ill. In the same flu outbreak, people with good constitution are not easily infected, while the weak are easily infected.
Constitutional strength and weakness, in Western medicine terms, is the strength of immunity. The human body has three immune organs: the lymphatics, the spleen, and the thymus. When these three major immune organs are damaged, immunity weakens. Cancer cells are cells derived from the body's own stem cells, present in almost everyone; the reason many people do not develop cancer is that their immune system monitors the cancer cells and kills them on its own.
People with weak constitution have poor immunity, and cancer cells easily take advantage of the deficiency. TCM holds that internal deficiency is mainly kidney deficiency and spleen deficiency. The TCM function of the kidney differs from the function of the kidney in Western anatomy; TCM kidney function includes a series of functions mentioned in modern medicine such as hematopoiesis and reproduction. It is actually a very complex concept; I will write separately on the TCM kidney in the future, so here I pass over it briefly.
Spleen deficiency is spleen-stomach weakness. The spleen is both an immune organ and a digestive organ. TCM holds that the kidney is the congenital root, and the spleen is the acquired root. A person with spleen deficiency can hardly absorb the nutrients from food. So a kidney-deficient person is congenitally deficient, and a spleen-deficient person is acquiredly deficient; with these deficiencies, the body becomes weak. TCM spleen-tonifying formulas such as Guipi Wan (Return-to-Spleen Pill) and Buzhong Yiqi Wan (Middle-Supplementing Qi-Boosting Pill), and kidney-tonifying formulas such as Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) and Jinkui Shenqi Wan (Golden Cabinet Kidney-Qi Pill), have a strong effect on raising immunity and resisting tumors. Some of our senior TCM physicians, such as Professor Fang Mingqian, when treating cancer, especially had the patient take spleen- and kidney-tonifying pills morning and evening to strengthen the kidney and spleen and raise self-immunity.
The imbalance doctrine is another important doctrine in TCM's cancer etiology. The Huangdi Neijing holds that the human body models itself on nature; only when "yin is calm and yang is tightly bound" can one be healthy and free of disease. If yin and yang are excess on one side, this is a state of "excess" (kang). "Excess brings harm; containment brings control." Excess is a state of going too far. "When yin is calm and yang is bound, the spirit is harmonized. When yin and yang separate and sever, the essential qi is exhausted." A person falls ill because the body's yin and yang have lost balance. Therefore one basic TCM idea of treating disease is analogous to neutralization in chemistry: by adjusting this imbalance, one brings it to a balanced state. Tonify yin for yin deficiency, tonify yang for yang deficiency, boost qi for qi deficiency, nourish blood for blood deficiency; finally, when the patient's body is in a balanced state, he recovers.
Besides yin-yang imbalance, the body's zang-fu organs can also be in a state of imbalance. TCM holds that the various organs of the body are mutually reinforcing; between them there is both mutual dependence and mutual restraint. Once they lose balance, the body's normal functions become disordered, and disorder of normal functions can lead to disease and even cancer. The imbalance of healthy and evil forces is also an important part of the imbalance doctrine; it was mentioned earlier, so I pass over it here.
The imbalance doctrine is also an important cancer-causing cause recognized by modern Western medicine. The body has tumor-suppressor genes; precisely because the body has lost its self-regulating balance, the tumor-suppressor genes fail to play their proper role, allowing cancer to grow.
TCM's important ideas for treating disease are drawn from Chinese Daoist philosophy. The Daoist idea of "reducing the surplus and supplementing the deficient" is precisely a balancing idea. When TCM treats disease, it adheres to "reducing the surplus and supplementing the deficient." The best state of the body is balance, not any one organ being either too strong or too weak.
In the Qian hexagram of the Zhouyi, this philosophical idea is well embodied. The best state is the fifth line (nine in the fifth place), which is approaching the peak but has not reached the highest peak, rather than the sixth line (nine at the top). At the sixth line's state, there is "the haughty dragon's remorse"—the Chinese traditional philosophical idea that going too far is as bad as not going far enough. Both excess and deficiency are states of imbalance. I hold a view that much of modern people's imbalance is caused by their own excessive greed and overstrong desires; some are caused by overly abundant material resources—ginseng and cordyceps eaten in massive amounts, to the point of being supplemented to death.
The six excesses among external causes refer to the various factors in the natural environment around us that are adverse to the body. In the past they meant wind, cold, summer-heat, dampness, dryness, and fire; today they should also include various forms of pollution. By the way, modern people living in urban apartments—the cooking fume produced in the kitchen when stir-frying is an important cancer cause. Nowadays more and more women get lung cancer, and this is related to many housewives inhaling too much cooking fume while doing kitchen work at home.
Dietary disorder includes eating out of time—not eating at fixed hours—and overeating rich, greasy, flavorful food. Breast and colorectal cancer are directly related to excessive intake of high-fat food. Disease enters through the mouth; this is entirely true. Modern medical research has found that about 30 to 40 percent of cancers are caused by improper diet. The Jisheng Fang says: "Excessively eating the five flavors, fish, meat, and cheese, and forcefully eating raw and cold fruits and vegetables, which accumulate and lodge in the stomach," will over time produce tumor-type diseases.
It is precisely these causes that lead to cancer. If we think carefully, many of us get cancer not by chance but by necessity, because our lifestyle and our way of dealing with people run directly against the natural laws the human body should follow.
Ancient TCM, under this guiding thought, carried out research on cancer treatment. Although cancer was not conquered by ancient TCM, the precious experience accumulated by generations of TCM physicians in treating cancer still plays an important role in the clinic today. By understanding TCM's view of cancer causes and carrying out related treatment, we can improve the odds of successfully fighting cancer.