Treating a Colon Cancer Patient with Liver Metastasis Using a 70% Support, 30% Expel Pathogen Approach

Doctor zhou October 31, 2019

After cancer patients undergo surgery and chemotherapy, most have a markedly deficient upright qi (zheng qi). For such patients, TCM treatment should focus on supporting zheng qi and consolidating the root, with expulsion of pathogen as a secondary measure. Even though tumor remains in their bodies, one should not again pursue aggressive pathogen-expelling treatment; otherwise it is easy for the patient to perish before the tumor is gone.

The patient introduced here is a native of Zouping, Binzhou City, Shandong Province, and was an employee of the Zouping Copper Mine, having long resided in Zouping County. She is a female patient with moderately differentiated adenocarcinoma of the colon that had metastasized to the liver, with peritoneal lymph node metastasis.

On September 16, 2018, the patient underwent right hemicolectomy plus partial hepatectomy at Zouping County People’s Hospital, followed by a total of twelve cycles of postoperative chemotherapy. When she came to see me, there were multiple enlarged lymph nodes in the abdominal cavity and retroperitoneum, a small amount of right pleural effusion, and a small nodular lesion in the lower lobe of the left lung.

The patient was born in March 1975 and had her first consultation with me on June 5, 2019. Her most recent examination was done on May 30, 2019, upon discharge after completing chemotherapy at the local hospital; at that time her white blood cell count was low and her liver and kidney function were impaired.

Four examinations in TCM: pulse slow, moderate, soft and forceless; teeth-marked tongue, pale and white with no coating. Urine was clear, bowel movements were regular, appetite acceptable, sleep acceptable. No bitter taste in the mouth; she drank a fair amount of water. At the onset of the illness, apart from abdominal pain and thinning of the stool, she had no other symptoms. She had chronic rhinitis for a long time, which has now improved. Her complexion was dark and turbid, her eyeballs slightly yellow, but without obvious jaundice. Her skin had long been on the yellowish side. Her menstruation had stopped after chemotherapy.

The most striking thing about this patient was her very dark complexion, which looked quite unhealthy. Given her condition, I decided on a treatment approach focused on supporting zheng qi and consolidating the root, supplemented by expelling pathogen and resolving tumor. I used Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction) plus an appropriate amount of anti-cancer Chinese herbs to mop up the metastatic tumors that still remained.

Decoction formula:

Raw Huangqi (Astragalus) 30g, Dangshen (Codonopsis) 15g, Baizhu (Atractylodes) 10g, Fuling (Poria) 10g, Zhi Gancao (honey-fried Licorice) 6g, Danggui (Angelica sinensis) 6g, Shudi (prepared Rehmannia) 6g, Chuanxiong (Ligusticum) 6g, Baishao (White Peony) 6g, Rougui (Cinnamon bark) 6g, Maidong (Ophiopogon) 6g, Wuweizi (Schisandra) 6g, Baijiangcao (Patrinia) 30g, Yiyiren (Coix seed) 60g, Banzhilian (Scutellaria barbata) 20g, Baihua She She Cao (Oldenlandia) 20g, Tengligen (Actinidia root) 30g, Shiwei (Pyrrosia) 30g, Xianhecao (Agrimonia) 30g, Sharen (Amomum) 6g, Jiao Shanzha (charred Hawthorn) 10g, Chao Maiya (fried Malt) 30g, Chenpi (tangerine peel) 6g, Fabanxia (processed Pinellia) 6g, Huangjing (Polygonatum) 15g

One packet per day, taken half an hour after meals, three times a day. The patent medicines may be swallowed with the decoction.

Patent medicines: Compound Mylabris Capsules (Guizhou Yibai Pharmaceutical), twice daily, 1–3 capsules each time; Hualiu Wan (Tumor-Resolving Pills), twice daily, 30–60 pills each time; Duoying Wan, twice daily, 5–15 pills each time.

Dietary prohibitions: seafood, crab, shrimp, rooster, carp, pickled foods, fried foods, spicy and greasy foods, grilled food, hot pot, citrus, sweet potato, white potato, glutinous rice products, sweets, etc.

Take the herbs for five days, then rest for two days. Stop the medication if you catch a cold with fever.

The patient returned for a follow-up visit on the afternoon of October 10, 2019.

Four examinations in TCM: right pulse moderate and soft, left pulse moderate and soft; slight teeth marks on the tongue; no stasis or purple discoloration under the tongue. Urination and defecation normal, sleep normal, appetite acceptable.

Before this visit, a hospital examination had shown that the residual abdominal lymph nodes had markedly shrunk, with no other changes; there was a small amount of pelvic effusion, and the pleural effusion was gone. White blood cells were normal. Her complexion had improved greatly and was no longer as dark and turbid as on the previous visit. The patient reported that during this period she danced square dance every day, and her quality of life was very good.

Considering that the medication was working, I followed the principle of “if effective, do not change the formula,” making only slight modifications to the original prescription and increasing the anti-tumor strength.

Decoction formula:

One packet per day, taken half an hour after meals, three times a day. The patent medicines may be swallowed with the decoction.

Patent medicines: Compound Mylabris Capsules (Guizhou Yibai Pharmaceutical), twice daily, 1–3 capsules each time; Bailian Dan, twice daily, 30–80 pills each time.

Dietary prohibitions and medication precautions are the same as before.

This patient’s condition was relatively serious; in terms of staging she was already at an advanced stage, because she had not only lymph node metastasis but also liver metastasis. Moreover, it was a moderately differentiated adenocarcinoma with a relatively high degree of malignancy, so the prognosis was not good. Yet under integrated Chinese-Western treatment, this patient was also able to quickly achieve very good results.

Personally, I think the reason this patient did so well, while certainly involving an element of luck, was more crucially related to the treatment plan chosen.

The patient promptly underwent surgery and chemotherapy, which greatly relieved the burden the tumor placed on her body. But she did not stubbornly cling to that highly invasive approach to the bitter end; she timely sought help from TCM. And the treatment approach I gave her was itself focused on supporting zheng qi and consolidating the root, so although her body had been greatly damaged by surgery and chemotherapy, she was still able to recover rapidly.

Objectively speaking, if this patient had chosen TCM alone or Western medicine alone, the results would not have been as good as the integrated Chinese-Western treatment she chose.

As an aside, the decoction I prescribed for this patient was based mainly on Shiquan Dabu Tang, supplemented with other herbs. In TCM, Shiquan Dabu Tang is a formula that simultaneously supplements yin, yang, qi, and blood—hence the name “Ten Complete Great Tonifying Decoction.” According to Japanese research, this formula is quite effective in cancer patients. The Japanese have also found that Shiquan Dabu Tang has a good repairing effect on liver damage in patients with impaired liver function.

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