Viewing Sino-Western Collaborative Anti-Cancer Treatment with Reason
The British anthropologist Nigel Barley wrote a book titled The Innocent Anthropologist, which mainly recounts the author's two periods of fieldwork among the Dowayo people of Cameroon in Africa.
In this book, Nigel Barley tells a joke. He says that when he was about to leave Britain for Cameroon to do anthropological research, his relatives and friends anxiously told him that Cameroon had cannibals and was too dangerous, urging him not to go. Later, after doing fieldwork for a while in Cameroon and befriending the village chief, when he was preparing to leave Africa for Britain, the African chief told him that he very much hoped to go with Nigel Barley to see Britain, but that he had heard Britain had cannibals who, unlike the peace-loving Africans, were very dangerous, so he had to give up the idea.
Between some adherents of TCM and some adherents of modern medicine, there exists just such an inexplicable and unbridgeable gulf as between those English and Cameroonians who each regard the other as cannibals. At the mention of TCM, its opponents immediately dismiss it as witchcraft and quackery; at the mention of modern medicine, die-hard TCM fans likewise turn up their noses, disparaging it in every way and ridiculing modern medicine in grossly distorted terms.
This mutual rejection born of ignorance directly affects the choices patients make in treating their own illnesses. Many patients and their families fear Western medicine like a tiger; other patients and their families turn pale at the very mention of TCM. They could have been treated better and lived longer through the joint efforts of Chinese and Western medicine, but regrettably they end up paying a heavy price for their prejudices against medicine.
I believe it is our responsibility to popularize medical common sense to society, recognizing both the strengths and the weaknesses of Chinese and Western medicine alike. What we should least do is create opposition between Chinese and Western medicine, exaggerate our own strengths, ridicule the other's weaknesses, manufacture prejudice and superstition, and mislead the public.
Not long after last year's epidemic ended, a breast cancer patient came to see me. Both her estrogen and progesterone receptors were positive; for such a patient, the treatment option most worth considering is endocrine therapy. But this patient had suffered severe side effects during endocrine therapy—intense pain all over her body. My advice to her was to use TCM as an adjunct to endocrine therapy, employing some TCM formulas to address the severe pain caused by the endocrine treatment, and to persist in carrying the endocrine therapy through; some of my patients with similar problems resolved them in exactly this way. Breast cancer patients whose estrogen and progesterone receptors are positive respond very well to endocrine therapy; conversely, if such patients do not receive endocrine therapy, their tumors progress faster than those of triple-negative breast cancer. At such a critical moment, a wrong choice causes irreparable loss.
But by then the patient had lost faith in Western medicine and was unwilling to try again. As it happened, a TCM doctor in her own locality was treating cancer with folk TCM remedies, reportedly with some successful cases. So she hoped to treat herself with pure TCM. Judging from my own many years of experience, the patient was giving up a high-success-rate treatment in favor of a very low-success-rate one, which I found most regrettable. But we cannot override any patient; in the end, the patient abandoned endocrine therapy. The skin lesions on her body began to ulcerate this year, and when she returned to Western medicine for targeted drugs, the effect was minimal.
I encounter similar patients almost every day. The day before yesterday, a patient with an occupying nodule in the lung flatly refused Western surgical treatment and demanded that I give him pure oral TCM treatment. I flatly refused. I told him that the surgical cure rate for early-stage lung cancer can exceed 90%, while the success rate of oral TCM treatment is below 10%; gambling with the patient's life in this way is not what a doctor should do. If a doctor, for personal profit, misleads the patient, trouble will come sooner or later.
Some patients trust me personally above all else, yet what they hope for is pure TCM treatment. I have indeed given pure TCM treatment to some patients for whom no Western-medical path remained; but where the patient still has an opportunity for surgery, or where the success rate of Western conservative treatment is higher, I do my best to persuade the patient and family to choose integrated Chinese-Western medicine to raise the success rate.
Before this year's Spring Festival, the mother of a child with neuroblastoma desperately wanted to abandon all Western treatment and begged me for pure TCM. But in fact, after the child received surgery and chemotherapy, TCM treatment would have a higher success rate. I spent a great deal of time working on this parent, and promised to provide TCM adjuvant therapy for the child during Western treatment, trying to keep the child's body in good condition. Later the child received Western treatment at the Shanghai Children's Medical Center while taking the Chinese herbs I prescribed. By the time the child's surgery and chemotherapy ended, the tumor burden had been greatly reduced, and during chemotherapy, thanks to the herbs, the blood picture had stayed good and appetite had been fine. This was a very fortunate outcome.
But as far as I know, when encountering similar patients, many TCM doctors resort to alarmism, exploiting the family's superstitious faith in TCM to frighten patients into refusing Western surgery and chemoradiation, so that these cancer patients' conditions are delayed. The widespread criticism in society of TCM—accusing some TCM doctors of misleading patients—is not without basis. Some TCM doctors reject Western medicine because they are too ignorant of Western medicine and modern biology; others have ulterior motives, exaggerating for personal gain and misleading patients. Whichever kind it is, such disregard for life is very dangerous.
A rigorous physician, in contact with patients, should strive to be objective, fair, reasonable and balanced, should keep learning, and should provide patients with as comprehensive information as possible. Toward fields one does not understand, one should maintain honesty and let the patient consult more specialized people. The doctor should help the patient and family make a rational choice, rather than inducing them to make a choice favorable to the doctor's income. To do otherwise is harmful in the long run, and we will suffer greatly in the practice of medicine. Many doctors have already paid a heavy price for doctor-patient disputes; we should learn from these warnings.
The scientific literacy of China's residents is still too low; many patients and their families lack medical common sense and are easily swayed by all manner of propaganda and prejudice. Other patients or families, having absorbed some paranoid views, hold overly high expectations of TCM or Western medicine. With such patients and families, one needs to explain the limitations of medicine even more carefully.
If, after explanation, the patient and family leave, or remain stubbornly deluded and make unrealistic demands of medical care, one should let them leave or persuade them to see a more skilled doctor, rather than retaining them for financial gain. Because such patients or families are very likely to lose their rationality when the treatment outcome is unsatisfactory, becoming a hidden danger in our professional lives. A doctor must be cautious; any slip in our work may become a lifelong nightmare for the patient, or for ourselves.