Veteran TCM Doctor Wang Taiyuan on Treating Breast Cancer with Chinese Medicine

Veteran TCM doctor Wang Taiyuan, in his eighties, practices in Guiyang and also has a solid Western medical foundation. He has deeply studied the treatment of gynecological diseases and once cured a breast cancer patient using pure TCM methods. Many other female cancer patients, after Western treatment, have sought him out for TCM care; by combining Chinese and Western medicine, he has kept some patients' conditions well controlled. I know one of Dr. Wang's patients: after Western surgery for cancer, she has continuously taken Chinese medicine under his care; five years on, under his regulation, all is well.

Dr. Wang has researched gynecological tumors extensively and wrote a book on the subject, which unfortunately could not be published. I was fortunate to obtain his unpublished, precious work condensing a lifetime of diagnostic and therapeutic insight, and I have gained much from studying his fifty-plus years of clinical experience. I here reprint Dr. Wang's unpublished article on breast cancer, hoping it will help fellow gynecological tumor patients. The copyright belongs to Dr. Wang Taiyuan; anyone reprinting it must state this. I hope everyone will respect the lifelong labor and intellectual property of an old medical worker of both virtue and skill.

I. Overview

Breast cancer is one of the malignant tumors of women. Worldwide, about 1.2 million women develop breast cancer each year and 500,000 women die of it. Its incidence accounts for 7%–10% of all systemic malignant tumors, ranking second among women, after cervical cancer. Male breast cancer is very rare, accounting for about 1% of breast cancer. Breast cancer is rare before age twenty; it increases with age, with an average age of forty to sixty, and tends to decline after sixty. The cause of breast cancer is not a single factor; many triggers are known. It is generally believed to relate to changes in sex hormones. Its early clinical signs are abnormal changes in the breast, such as a palpable lump or thickening, a feeling of fullness, dimpling, coarse or reddened skin, deformed or retracted nipple, or scaling, nipple discharge, pain or tenderness. A painless breast mass is often the first symptom, accounting for over 95%; other signs—slight breast discomfort or pain, and nipple discharge—account for about 5%.

Clinically, breast cancer corresponds in our medicine to the categories of "rock breast" (ru yan), "jealous breast" (du ru), and "breast stone abscess" (ru shi yong). It is often related to melancholy, brooding, anger, and emotional injury; disordered liver and spleen qi; binding of toxin evil; insufficiency of liver and kidney; and disorder of the thoroughfare and conception vessels.

II. Diagnosis

1. Breast mass: early on there are no subjective symptoms; occasionally a small, painless, solitary lump is found, hard in quality, smooth-surfaced, with indistinct borders, relatively fixed, and generally growing rapidly.

2. When the cancer invades the skin, the local skin becomes dimpled.

3. If cancer cells block the subcutaneous and intradermal lymphatics, local lymphedema occurs, forming an "orange-peel" change.

4. In the late stage, the cancer invades the thoracic fascia and chest muscles, and cancer cells infiltrate large areas of skin, forming many hard nodules that fuse into sheets extending toward the back and opposite chest, tightening the chest wall and restricting breathing.

5. The cancer ulcerates into an ulcer, foul-smelling and easy to bleed, shaped like a single crater or a cauliflower.

6. The nipple reddens; a cancer near the nipple may pull the nipple toward the tumor, while a deep cancer retracts the nipple.

7. Lymphatic metastasis: first in the axilla; if the main lymphatics there are blocked by cancer cells, upper-extremity lymphedema may result. Lymph nodes beside the sternum and above the clavicle may also be involved.

8. Modern mammography (molybdenum-target films), liquid-crystal thermography, and fine-needle aspiration cytology can all help confirm the diagnosis.

III. Pattern Differentiation and Treatment

Since breast cancer belongs to the "rock breast" category of our medicine, Chinese medicine still has some effect if treated early. But if discovered and treated late, the breast must be surgically removed as soon as possible, followed by integrated Chinese-Western treatment; most patients can prolong their lives or be cured. TCM pattern differentiation and treatment are as follows:

1. Liver-qi depression and qi stagnation pattern: this is mostly seen in the early stage; onset relates to mental stress. Signs: distending pain in the breast lump, fullness in both hypochondria, irritability, bitterness in the mouth, dry throat, dizziness and vertigo, a thin yellow tongue coating, and a wiry, slippery pulse.

Treatment: soothe the liver and regulate qi; resolve phlegm and disperse nodules.

Formula: Modified Free-and-Easy Wanderer Powder (Xiaoyao San). Bupleurum (Chaihu), green Tangerine peel (Qingpi), Curcuma aromatica (Yujin), tangerine leaf (Juye), Angelica (Danggui), White Peony (Baishao), Poria (Fuling), Angelica dahurica (Baizhi), Atractylodes macrocephala (Baizhu) each in appropriate grams; whole Trichosanthes (Gualou) 30 g; Cremastra (Shancigu) 15 g.

Administration: Decoct in water; one dose daily.

2. Binding of heat-toxin pattern: mostly seen in the middle and late stages, when the cancer has ulcerated and decayed. Signs: rapid enlargement of the breast mass, pain, occasional redness and swelling, or ulceration and cauliflower-like eversion with foul, putrid discharge; sallow complexion, emaciation and fatigue, or fever and irritability, dry mouth and constipation; a red tongue with yellow greasy coating; a wiry rapid or slippery rapid pulse.

Treatment: resolve toxin and stasis; support the righteous and expel evil.

Formula: Ranunculus ternatus (Maoyuancao), whole Trichosanthes (Gualou), Dandelion (Pugongying), unprocessed Astragalus (Sheng Huangqi) each 30 g; Cotton leaf (Furongye) 20 g; Cremastra (Shancigu), Scutellaria (Caohuoche), unprocessed Rehmannia (Shengdi) each 15 g; Scrophularia (Xuanshen) 12 g; Salvia chinensis (Liujinu), wasp nest (Lufengfang), Angelica (Danggui) each 10 g.

Administration: Decoct in water and divide into two doses.

3. Disorder of the thoroughfare and conception vessels pattern: mostly seen in middle-aged and elderly women. Signs: breast mass with fullness, irregular menstruation, sore and weak loins and knees, dizziness and vertigo, feeling of heat in the palms, soles, and chest, night sweats and insomnia; dry, rough eyes, dry mouth; a red, cracked tongue with little coating; a thin, rapid, forceless pulse.

Treatment: regulate the thoroughfare and conception vessels; nourish and tonify the liver and kidney.

Formula: Modified Rehmannia, Chrysanthemum, and Wolfberry Pill (Qiju Dihuang Wan). Prepared Rehmannia (Shudi), Lycium (Gouqi), White Peony (Baishao), Dioscorea (Shanyao), wild Chrysanthemum (Yejuhua) each 15 g; Cyperus (Xiangfu), Curcuma aromatica (Yujin), Melia (Chuanlianzi), Ligusticum (Chuanxiong), tangerine leaf (Juye), Ligustrum (Nüzhenzi) each 10 g; whole Trichosanthes (Gualou) 30 g.

Administration: Decoct in water; one dose daily, divided into two.

4. Dual deficiency of qi and blood pattern: mostly seen after surgery or chemotherapy; signs: sallow complexion, fatigue and shortness of breath, lassitude, reluctance to speak, poor appetite and loose or dry stools, pale-white lips, dizziness and vertigo, palpitations and insomnia, numbness of the limbs, scant menstruation or even amenorrhea; a pale tongue with white coating; a thin, forceless pulse.

Treatment: boost qi and nourish blood; strengthen the spleen and calm the spirit.

Formula: Modified Return-of-the-Spleen Decoction (Guipi Tang). Ginseng (Renshen), Atractylodes macrocephala (Baizhu), Zizyphi spinosi seed (Suanzaoren), Longan aril (Longyanrou), Poria Spirit (Fushen) each 10 g; Astragalus (Huangqi) 8 g; Angelica (Danggui) 5 g; Polygala (Yuanzhi), costus (Muxiang), Ginger (Shengjiang) each 2 g.

Modification: This pattern may also be regulated with Eight-Treasures Decoction (Bazhen Tang).

IV. Single Herbs and Proven Prescriptions

1. Bupleurum (Chaihu), Aurantium (Zhiqiao), processed Cyperus (Zhi Xiangfu), Trichosanthes peel (Gualou qiao), green Tangerine peel (Qingpi) each 9 g; White Peony (Baishao) 12 g; Curcuma aromatica (Yujin), Prunella (Xiakucao) each 6 g; Angelica tail (Dangguiwei), Oyster shell (Muli) each 15 g; Licorice (Gancao) 3 g. Decoct in water; divide into two doses; one dose daily. This soothes the liver and regulates qi, softens hardness and activates blood; it suits early breast cancer.

2. Green tangerine leaf (Qing Juye), green Tangerine peel (Qingpi), tangerine seed (Juke) each 15 g; white liquor 250 g. Put the tangerine leaf, green peel, and tangerine seed in a container, add 250 g each of yellow wine and water, and boil down to 200 g; strain and divide into two warm drinks. One dose daily. This reduces swelling and disperses nodules, prevents and fights cancer; suitable for early-stage breast cancer.

3. Tangerine leaf (Juye) 30 g; Tangerine peel (Jupi), tangerine seed (Juke) each 20 g; tangerine pith (Ju luo) 10 g. Sort and wash the tangerine leaf, peel, seed, and pith, and dry. Chop the leaf and peel, crush the seed, and place all together with the pith in a clay pot; add appropriate water, soak briefly, and decoct for 30 minutes. Strain through clean gauze, remove the dregs, put the juice in a container, and drink warm, twice a day (morning and evening). This soothes the liver and regulates qi, resolves depression and fights cancer; suitable for early-stage breast cancer.

4. Raw crab shell 250 g. Wash the crab shells, sun- or oven-dry, roast until yellow, and grind into a fine powder; bottle and keep away from moisture for later use. Twice daily, 6 g each time, taken with warm water. Especially suitable for breast cancer that has not ulcerated.

5. Dandelion (Pugongying), Viola (Zihua Diding), Polygala (Yuanzhi), Cinnamon (Rougui) each 10 g; whole Trichosanthes (Gualou) 60 g; Pangolin scales (Chuanshanjia), Trichosanthes root (Tianhuafen), Red Peony (Chishao), Licorice (Gancao) each 6 g; Prunella (Xiakucao), Honeysuckle (Jinyinhua), unprocessed Astragalus (Sheng Huangqi), White Peony (Baishao), Platycodon (Jiegeng), Curcuma zedoaria (Ezhu) each 15 g; Angelica (Danggui) 30 g. Decoct three times, take after meals; one dose daily. This clears heat and resolves toxin, boosts qi and activates blood, reduces swelling and disperses nodules; suitable for breast cancer with righteous deficiency and binding of heat toxin.

6. Prunella (Xiakucao), Honeysuckle (Jinyinhua), Forsythia (Lianqiao) each 18 g; Trichosanthes peel (Gualou pi) 30 g; Chrysanthemum (Juhua) 15 g; Cremastra (Shancigu) 12 g; Tangerine peel (Chenpi), Frankincense (Ruxiang), Myrrh (Moyao), Sophorae tonkinensis (Shan Dougen) each 9 g. Decoct in water; divide into two doses; one dose daily. This clears heat and resolves toxin, regulates the spleen and clears the liver, opens blockage and accumulations, and regulates qi and resolves phlegm; suitable for the heat-toxin binding pattern of breast cancer.

7. Scutellaria barbata (Banzhilian), Phellodendron (Huangbai), Honeysuckle (Jinyinhua), Melia (Chuanlianzi) each 15 g; Carapax Trionycis (Biejia), cactus (Xianrenzhang) each 12 g; Hawthorn (Shanzha) 50 g; Pangolin scales (Chuanshanjia) 6 g; wild Chrysanthemum (Yejuhua), Orostachys (Wasong) each 100 g. Decoct in water; divide into two doses; one dose daily. This resolves toxin and disperses nodules; suitable for the heat-toxin binding pattern of breast cancer.

8. Garlic 15 g. Wash, peel, and slice the garlic, put in a pot with appropriate water, boil for 20 minutes, and take all at once. This resolves toxin and fights cancer; suitable for the heat-toxin binding type of breast cancer.

9. Ligustrum (Nüzhenzi), Scutellaria barbata (Banzhilian), Salvia chinensis (Liujinu), Solanum nigrum (Longkui) each 30 g; Eclipta (Hanliancao), unprocessed Rehmannia (Shengdi), Scrophularia (Xuanshen), Cremastra (Shancigu), Salvia (Danshen), whole Trichosanthes (Gualou) each 15 g; Cornus (Shanzhuyu), Sargassum (Haizao) each 10 g. Decoct in water; divide into two doses; one dose daily. This nourishes and tonifies the liver and kidney, resolves phlegm and stasis; suitable for breast cancer with liver-kidney yin deficiency.

10. Sargassum (Haizao), kelp (Haidai), Cassia seed (Juemingzi) each 30 g; Ligustrum (Nüzhenzi), Honeysuckle (Jinyinhua), Salvia (Danshen), prepared Rehmannia (Shudi) each 15 g; Poria (Fuling), Lycium (Gouqi), Dendrobium (Shihu) each 12 g; Pseudostellaria (Taizishen) 9 g. Decoct in water; divide into two doses; one dose daily. This boosts qi and nourishes yin, reduces swelling and disperses nodules; suitable for late-stage breast cancer with dual deficiency of qi and yin.

11. Cyperus (Xiangfu), Curcuma aromatica (Yujin), Melia (Chuanlianzi), Ligustrum (Nüzhenzi), Ligusticum (Chuanxiong), tangerine leaf (Juye) each 10 g; Angelica (Danggui) 12 g; unprocessed Rehmannia (Shengdi), prepared Rehmannia (Shudi), White Peony (Baishao), Lycium (Gouqi), unprocessed Dioscorea (Sheng Shanyao), wild Chrysanthemum (Yejuhua) each 15 g; Trichosanthes (Gualou) 30 g. Decoct in water; divide into two doses; one dose daily. This nourishes and tonifies the liver and kidney and regulates the thoroughfare and conception vessels; suitable for breast cancer with liver-kidney insufficiency and disorder of the thoroughfare and conception vessels.

12. Asparagus (Tiandong) 8 g; green tea 2 g. Sort and wash the Asparagus, dry, and cut into slices; put with green tea in a cup, pour on boiling water, cover and steep for 15 minutes, then drink. Sip frequently as tea; it can usually be steeped 3–5 times. When reaching the end, the Asparagus slices can be chewed and swallowed. This nourishes yin, moistens the lung, and downbears fire; suitable for early breast cancer.

13. Unprocessed Astragalus (Sheng Huangqi) 60 g; Poria (Fuling), Corydalis (Yanhusuo) each 15 g; Angelica (Danggui), unprocessed Oyster shell (Sheng Muli) each 30 g; Pangolin scales (Jiazhu), wasp nest (Lufengfang), Paris (Zaoxiu), Tinospora (Jingulan), snake slough (Shetui) each 9 g; Centipede (Wugong) 5 g; Notoginseng (Sanqi) 3 g; Trogopterus (Wulingzhi) 12 g; Prunella (Xiakucao) 10 g. Decoct in water; divide into two doses; one dose daily. This boosts qi and nourishes blood, resolves toxin and softens hardness; suitable for breast cancer with qi deficiency and blood stasis.

14. Unprocessed Astragalus (Sheng Huangqi), Codonopsis (Dangshen), Glehnia/Adenophora (Shashen), Houttuynia (Yuxingcao), Prunella (Xiakucao), Dandelion (Pugongying) each 30 g; Hawthorn (Shanzha) 20 g; Atractylodes macrocephala (Baizhu), Asparagus (Tiandong), Lobelia (Banbianlian) each 15 g; Oldenlandia (Baihua Sheshecao), Scutellaria barbata (Banzhilian) each 60 g; Poria (Fuling) 10 g. Decoct in water. Start taking one week after surgery; take one dose daily for three years, then reduce the frequency as appropriate to maintain for 5–6 years. This supports the righteous and regulates qi, and clears heat and resolves toxin; suitable for breast cancer after surgery.

15. Codonopsis (Dangshen) 30 g; unprocessed Astragalus (Sheng Huangqi) 20 g; Jujube (Hongzao) 15 pieces; round-grained rice 250 g; brown sugar 20 g. Wash the Codonopsis and Astragalus separately, slice, and put in a clay pot; add water and decoct twice, 30 minutes each time, combining the two decoctions. Wash the jujubes and rice, put in a pot, add the Codonopsis-Astragalus decoction and appropriate water and brown sugar, and cook into rice as usual; serve as a staple with meals. This strengthens the spleen and boosts qi, and raises white blood cells; suitable for breast cancer patients with myelosuppression and falling white blood cells after radiotherapy and chemotherapy.

16. Spatholobus (Jixueteng) 50 g; Jujube (Hongzao) 10 pieces. Wash both and put in a pot with appropriate water; decoct 30 minutes each time and combine the decoctions; chew the jujubes while taking. This nourishes and invigorates blood and raises white blood cells; suitable for leukopenia after radiotherapy and chemotherapy for breast cancer and other cancers.

17. Prunella (Xiakucao), Oyster shell (Muli) each 30 g; Sargassum (Haizao), kelp (Kunbu), Trichosanthes root (Tianhuafen), wasp nest (Lufengfang) each 9 g; Scrophularia (Yuanshen), Bolbostemma (Tu Beimu) each 15 g; Centipede (Wugong) 2. Decoct in water; suitable for breast cancer with binding of phlegm and qi stasis.

18. Trichosanthes (Gualou), unprocessed Rehmannia (Shengdi) each 150 g; Fritillaria (Beimu), Cyperus (Xiangfu), Oyster shell (Muli) each 120 g; Rhaponticum (Loulu), white Mustard seed (Baijiezi), Poria (Fuling), stir-fried Barley (Chao Maiya) each 90 g; Vaccaria (Wangbuliuxing), processed Pinellia (Banxia), Angelica (Danggui), tangerine leaf (Juye), stir-fried Atractylodes (Chao Baizhu), green Tangerine peel (Qingpi), Tangerine peel (Chenpi) each 60 g; Pangolin scales (Jiazhu), Akebia (Mutong), Ligusticum (Chuanxiong), Licorice (Gancao) each 30 g. Grind all into a fine powder; three times daily, 6 g each time. This regulates qi and resolves phlegm, activates blood and disperses nodules; suitable for breast cancer and breast cysts of the phlegm-stasis binding type.

19. Whole Trichosanthes (Gualou) 90 g; Moutan (Danpi), Honeysuckle (Jinyinhua), wasp nest (Lufengfang), snake slough (Shetui), Scorpion (Quanxie) each 60 g. Grind all into a fine powder and make into water-paste pills the size of mung beans; take 3–6 g each time, three times daily, washed down with Astragalus decoction or boiled water. This soothes the liver and resolves toxin, softens hardness and resolves stasis, reduces swelling and stops pain; suitable for breast cancer.

20. Processed Strychnos (Maqianzi) 0.1 g; live snail 0.5 g; Centipede (Wugong) 1.5 g; wasp nest (Lufengfang) 0.5 g; Scorpion (Quanxie) 0.3 g; Frankincense (Ruxiang) 0.1 g. The above is a one-day dose; grind into a fine powder and make into water-paste pills; take in three divided oral doses. This activates blood and resolves stasis, unblocks the channels and disperses nodules; suitable for breast cancer.

21. Solanum nigrum (Longkui), Angelica dahurica (Baizhi), Dandelion (Pugongying) each 30 g; Duchesnea (Shemei), Ficus pumila fruit (Bili guo), Paris (Zaoxiu) each 15 g. Decoct in water; divide into two doses; one dose daily. This fights cancer; suitable for breast cancer.

22. Bolbostemma (Tu Beimu) 500 g; Cyperus (Xiangfu) 250 g; Pangolin scales (Jiazhu) 250 g. Grind these three into a fine powder, bottle for later use; twice daily, 3 g each time. This clears heat and resolves toxin, moves qi and reduces swelling, and disperses nodules and fights cancer; suitable for the heat-toxin binding type of breast cancer.