Three Keys of TCM Cancer Treatment: Supporting Right Qi, Expelling Pathogens, and Symptomatic Treatment

There are three essentials to master in TCM treatment of cancer: first, supporting the right qi (fuzheng); second, expelling the pathogen (quxie); and third, symptomatic treatment.

Right-supporting treatment can raise the patient's immunity and restore their strength. Most cancer patients are deficient, so supporting the right qi is very necessary. When the right qi is exuberant, the pathogen easily recedes, just as the Huangdi Neijing says: "When right qi is stored within, the pathogen cannot assail."

How, then, should right-supporting treatment be carried out? Many people often ask me whether cancer patients have yin deficiency or yang deficiency. In my own clinical experience, few cancer patients are purely yin-deficient, and few are purely yang-deficient; the great majority are deficient in both yin and yang. As the famous Ming physician Zhang Jingyue said: "Yin is not excessive, and yang is often insufficient."

Most cancer patients have both insufficiency of yin fluids and signs of yang deficiency with cold limbs. This simultaneous deficiency of yin and yang requires supplementing both yin and yang during treatment. But different patients, or the same patient at different times, may differ in which side—yin or yang—is more deficient.

Views that all cancer patients are yang-deficient, or that all are yin-deficient, are extreme. Blindly warming yang with Fuzi (Aconite), Guizhi (Cinnamon Twig), and Ganjiang (Dried Ginger), or blindly nourishing yin and clearing heat, easily leads to the fault of one-sided medication.

Nowadays some people advocate taking Fuzi and other yang-warming drugs regardless of the patient's constitution. In my own clinical experience, many patients who took Fuzi for a while developed what TCM calls "fire rising while the pan dries": scorching heat unbearable, worse than death. Other patients overused cold-cooling herbs, damaging their spleen yang so that food was not transformed. Unfortunately, most patients themselves do not understand this; after an initial improvement they believe the drugs can be taken long-term.

For cancer patients with mild symptoms, whether warming yang or nourishing yin, one should use moderate formulas. For nourishing yin choose Mohanlian (Eclipta), Nüzhenzi (Ligustrum), Huangjing (Polygonatum), Yuzhu (Polygonatum odoratum), and Jiaogulan (Gynostemma); use bitter-cold herbs cautiously. For warming yang choose Tusizi (Cuscuta), Shayuanzi (Astragali complanati), Bajitian (Morinda), Yinyanghuo (Epimedium), and Xianmao (Curculigo); use Fuzi and Guizhi cautiously. Any Chinese herb with strong force and heavy qi may be used briefly but not long-term; long-term use inevitably brings trouble.

Some people constantly cite famous doctors like Li Ke to promote yang-warming cancer treatment. When Dr. Li Ke was alive, I had contact with quite a few of his patients; some came to me after his treatment failed. After Li Ke used Fuzi, many patients not only saw their tumors grow rapidly but also became unbearably hot and dry. This yang-warming master's cancer results were not as good as his modern admirers claim.

Zhang Jingyue said: "He who is good at supplementing yang seeks yang within yin, so that yang is aided by yin and transforms endlessly; he who is good at supplementing yin seeks yin within yang, so that yin is raised by yang and its source never runs dry." When using yang-supplementing formulas, one must consider that warming-yang herbs are too rigid and dry, and should be accompanied by yin-nourishing herbs to avoid over-dryness damaging yin. When using yin-nourishing formulas, one should also consider that yin-nourishing herbs are cloying and obstruct the diaphragm, and should be assisted by yang-raising herbs to stimulate the spleen and kidney yang.

When using right-supporting tonics, one should also refer to the Ming physician Wang Qishi's idea, in his Lixu Yuanjian, of simultaneously tonifying the lung, spleen, and kidney. TCM often says the kidney is the congenital root and the spleen the acquired root, so clinically one must supplement the kidney and fortify the spleen. Tonifying the spleen and kidney is certainly important, but the patient's lung must also be attended to.

Insufficiency of lung qi or lung yin both greatly damage the patient's original qi. That is why the Republic-of-China physician Zhang Xichun always added Maidong (Ophiopogon) and Tiandong (Asparagus) to liver- and kidney-supplementing formulas to tonify the lung—worth referring to.

As for pathogen-expelling treatment, that is the attack on the tumor. The basic treatment principles include: using poison to attack poison (yidu gongdu), activating blood and resolving stasis (huoxue huayu), breaking blood and dispersing swelling, softening hardness and dissipating nodules, and clearing heat and resolving toxin.

Among these, using poison to attack poison is the key to treating tumors, and also the difficulty. Tumors cannot be fundamentally resolved without poison-attacking-poison methods, but if the dosage is not well controlled, poison-attacking-poison can easily cause the patient to overdose on the toxin, leading to death or disability.

The medical team led by former Health Minister Chen Zhu made a major breakthrough in using arsenic (pit frost) to treat leukemia; this treatment is a typical TCM example of using poison to attack poison.

Ancient TCM treatment of cancerous tumors often used poison-attacking-poison agents such as arsenic (pi shuang), blister beetle (ban mao), red ladybug (hong niangzi), croton cream (ba dou shuang), and calomel (qing fen). The contemporary famous anti-cancer physician Sun Bingyan was known throughout his life for his skill in using poison to attack poison.

Poisonous herbs can kill cancerous tumors, but they can also kill the patient. If the dosage is not mastered, medical accidents easily occur. Given how serious current medical-dispute problems are, fewer and fewer doctors now dare to use poison to attack poison; everyone is used to writing "peaceful prescriptions," seeking no merit but only avoiding fault.

Besides poison-attacking-poison, activating blood and resolving stasis is another major method commonly used in cancer treatment. Switzerland also conducted a large clinical trial using the Western blood-activating drug aspirin; the statistics show that activating-blood-and-resolving-stasis treatment can indeed prolong cancer patients' survival.

But the drawbacks of blood-activating therapy also exist. Some scholars point out that blood-activating herbs such as Danshen (Salvia), Shuizhi (leech), and Chishao (Red Peony) may promote cancer-cell metastasis. And blood-activating herbs like Sanqi (Pseudoginseng) can easily cause cancer embolus in patients. I have clinically seen three patients who took Sanqi powder on their own and finally developed cancer embolus and died despite treatment.

TCM cancer treatment has another important task: symptomatic treatment. This is a kind of supportive therapy aimed at improving the patient's quality of life. Based on the various clinical symptoms that appear, it treats the common complications of cancer patients.

For example, some cancer patients develop fever, pleural effusion, ascites, abdominal distension, or cancer pain; these can also be relieved through TCM. Other patients, after surgery, radiotherapy, or chemotherapy, develop corresponding complications or sequelae that no Western method can relieve; these can also be treated with TCM, in which TCM has strong advantages.

A clinical TCM physician who has mastered these three essentials, who has read the TCM internal- and external-medicine classics thoroughly, and who keeps in mind more than five hundred classic and proven formulas suitable for tumor patients will treat cancer in an orderly way, with clear confidence. Yet mastering and skillfully applying these three essentials is no easy task; it truly tests a TCM physician's foundational skill.

Of course, for very advanced patients, no matter how excellent the physician's skill, it cannot achieve much. When receiving a patient, a physician should be factual and tell the patient or family honestly, not exaggerate or boast about efficacy, and not let the patient or family harbor unrealistic illusions; ultimately, when treatment fails, medical disputes easily arise.