Three Commonly Used TCM External Plasters for Pain Relief and Anti-Tumor Effects

Using plasters for external treatment is a traditional TCM therapy. Some traditional plasters have a certain efficacy in relieving pain in tumor patients. These plasters not only have analgesic effects but can, in some lucky patients, also shrink tumors. Of course, the effective rate of all anti-tumor drugs is not very satisfactory, so relying solely on external plasters to treat tumors is unrealistic, but these external medicines can be used as adjuvant medications.

Here I introduce three commonly used plasters. These are all Chinese patent medicines that patients can buy themselves; in some places they can even be prescribed through medical insurance.

The first is Awei Huapi Gao (Asafetida Abdominal Massages-Resolving Plaster).

Awei Huapi Gao is a formula recorded in Chen Shigong's "Orthodox Manual of External Medicine" from the Ming Dynasty. This is a formula devised by Chen Shigong himself. Chen Shigong commonly used Herong Sanjian Wan (Harmonizing and Hard-Dissolving Pill) internally and Feilong Awei Huajian Gao (the present-day Awei Huapi Gao) externally, in combination to treat "shirong zheng" (i.e., lymphatic metastasis in various late-stage cancers), goiter and tumors, breast rock (i.e., breast cancer), scrofula, and concealed syphilitic lesions. For any mass that "at first is hard as stone, with the skin not reddened, gradually enlarging over time, whether painful or not, but unruptured, apply this plaster."

Chen's evaluation of the efficacy of these two formulas was objective. He believed that Herong Sanjian Wan and Feilong Awei Huajian Gao could extend patients' survival time. In "Orthodox Manual of External Medicine," Chen Shigong said that using this formula he had "treated several people; although they were not completely cured, they did not die prematurely. It is truly a life-prolonging medicine."

Chen specialized in external medicine and founded one of the three major schools of TCM external surgery, the "Orthodox School." The majority of diseases he treated in his lifetime were external surgical diseases, and quite a few were malignant tumors. Awei Huapi Gao was a plaster formula Chen Shigong used throughout his life, and its clinical efficacy was affirmed by later physicians. Professor Zhao Shaoqin, a renowned master of the contemporary Warm Disease school in China, commonly used Awei Huapi Gao to treat various malignant tumors.

Awei Huapi Gao is composed of many Chinese medicinal herbs: Ezhi (Chinese asafetida), Baizhi (Angelica dahurica), Baimazi (Ricinus communis seeds), Danggui (Angelica sinensis), Houpo (Magnolia officinalis), Huanglian (Coptis chinensis), Moyao (Commiphora myrrha), Rougui (Cinnamomum cassia bark), Sheng Caowu (raw Aconitum kusnezoffii root), Shijunzi (Quisqualis indica), Xionghuang (realgar), Sanleng (Sparganium stoloniferum), Ezhu (Curcuma zedoaria), Sheng Chuanwu (raw Aconitum carmichaelii root), Mumiezi (Momordica cochinchinensis), Qianglang (Catharsius molossus), Dahuang (Rheum palmatum), Ruxiang (Boswellia carterii), Xiangfu (Cyperus rotundus), Luhui (Aloe), Xuejie (Dracaena draco resin), Zhangnao (camphor), and others.

Ready-made products are available on the market. Specifications include 6g net weight per plaster and 12g net weight per plaster; the 12g version has better efficacy than the 6g version. When using it, one can heat it up (I generally advise patients to use a hair dryer) to soften it, then apply it to the navel and the skin over the affected area, achieving transdermal delivery. If the skin is ulcerated or the patient develops a skin allergy after use, do not use it. Each plaster can be left on for 3-5 days and changed when bathing.

According to traditional TCM theory, the main effect of Awei Huapi Gao is to resolve abdominal masses and eliminate accumulations. It can be used for abdominal pain and chest and hypochondriac fullness caused by various tumors of the qi stagnation and blood stasis type. It is suitable for masses in multiple organs and gynecological tumors of the liver, gallbladder, stomach, lung, esophagus, intestine, bladder, and kidney.

The second plaster is Chansu Zhentong Gao (Toad Venom Analgesic Plaster).

Chansu Zhentong Gao is also a Chinese patent plaster developed on the basis of the ancient external plaster formula Chansu Gao (Toad Venom Plaster). Its main ingredients are: Chansu (toad venom), Sheng Maqianzi (raw Strychnos nux-vomica seeds), Sheng Tiannanxing (raw Arisaema heterophyllum tuber), Sheng Chuanwu (raw Aconitum carmichaelii root), Xionghuang (realgar), Baizhi (Angelica dahurica), Jianghuang (Curcuma longa), Biantilian (Lobelia chinensis), Zhangnao (camphor), and others.

The main effect of this plaster is to reduce swelling and dissipate nodules, reduce swelling and relieve pain. It is suitable for the analgesia and dissipation of various masses, and also for pain caused by muscle strain, bone spurs, and arthritis.

Chansu (toad venom) is a commonly used anti-cancer drug in TCM, suitable for both internal and external use. In ancient times there was also a therapy of directly soaking toad skin in yellow rice wine and applying it externally to tumors. Wang Hongxu in "Quan Sheng Ji" (Complete Collection of External Medicine) also introduced another method: taking an old toad, breaking open its abdomen with the entrails, and applying the whole thing externally to the mass. However, this treatment method is rather cruel, and in the author's experience, the simple external use of toad skin and toad is not very effective against tumors; it may be more effective against certain inflammatory masses. So I do not recommend using this method for malignant tumor patients.

Toad skin is a thin layer of skin that toads naturally shed. When soaked in yellow rice wine and applied externally to surface tumors, it does indeed have a certain efficacy. When Chansu Zhentong Gao cannot be purchased, one can try it; Chansu Zhentong Gao is not easy to buy. However, much of the toad skin on the market has already had the toad venom extracted and has lost its therapeutic efficacy, so one must choose carefully when purchasing.

The Sheng Maqianzi (raw Strychnos), Sheng Tiannanxing (raw Arisaema), Sheng Chuanwu (raw Aconitum), and Xionghuang (realgar) in this formula are all highly toxic drugs. Whenever the skin is ulcerated or the tumor has ruptured, they should not be used. Some patients experience side effects when using Chansu Zhentong Gao. The common side effects are skin itching or a burning sensation; occasional skin flushing may occur, and these can all be continued. But if it causes allergic reactions such as rash or herpes, use should be stopped and the affected area painted with 1% gentian violet, which will heal in a few days.

The third plaster is Chanwu Babugao (Toad and Aconitum Cataplasm).

The ingredients of Chanwu Babugao are: Chansu (toad venom), Chuanwu (Aconitum carmichaelii root), Liangmianzhen (Zanthoxylum nitidum), Chonglou (Paris polyphylla), Guanbaifu (Aconitum coreanum), Sanleng (Sparganium stoloniferum), Ezhu (Curcuma zedoaria), Xixin (Asarum sieboldii), Dingxiang (Syzygium aromaticum), Rougui (Cinnamomum cassia bark), Ruxiang (Boswellia carterii), Bingpian (borneol), and others.

Its main effect is to activate blood and resolve stasis, reduce swelling and relieve pain. This is a commonly used external analgesic and anti-swelling drug in oncology departments. It can be used for pain caused by various cancers of the lung, liver, stomach, and others. The plaster can be applied directly to the skin over the affected area or the painful site: one patch each time, changed every 1-3 days.

However, because this formula uses Xixin (Asarum), which belongs to the Aristolochiaceae family, it must be used with caution; patients with renal insufficiency should be strictly prohibited from using it. Unless it is for late-stage palliative care, patients are generally not advised to use it.

Chanwu Babugao is a cataplasm made using modern pharmaceutical technology; it has good absorption when delivered transdermally and relieves pain quickly. Clinical trials have confirmed that Chanwu Babugao was used to treat 120 patients with advanced lung cancer; after medication, pain was relieved in as many as 105 cases, with a total effective rate of 87.5% and an average analgesic duration of 11.5 hours. It treated 102 cases of liver-area pain after interventional therapy for liver cancer; after medication, pain was relieved in 90 cases, with a total effective rate of 84.6% and an average analgesic duration of up to 11.3 hours.

This analgesic effect is quite ideal, and transdermal plasters generally do not cause the constipation and excessive sweating that painkillers like OxyContin cause. So this pain-relief regimen is very valuable for improving the quality of life of late-stage cancer patients.

However, all three of these external plasters with anti-swelling and analgesic effects contain highly toxic drugs, so they are strictly prohibited for pregnant women and also prohibited for those with ulcerated skin. Some external plasters, such as Jiangdan, can easily cause tumors to rupture, and must be used with extreme caution. The author has seen many patients who used such external medicines on their own, rupturing surface tumors, after which the sores could no longer be healed, resulting in extremely poor quality of life. So for patients whose tumors show signs of rupturing, external medicines must be used with great caution.

External plasters are generally also relatively expensive. When choosing such medicines, patients should comprehensively consider their own financial means and select a regimen suitable for themselves.