TCM Case Record of Elderly Physician Wang Taiyuan Treating a Stage 3C Ovarian Cancer Patient (Survived Five Years, No Recurrence to Date)

This is the case record of elderly TCM physician Wang Taiyuan treating a stage 3C ovarian cancer patient, Liu. The patient was found to have ovarian cancer in 2010; postoperative pathology showed stage 3C, i.e., middle-to-late stage. After two years of taking Wang's herbal medicine alongside chemotherapy, the patient contacted me hoping I would continue treatment. Because Physician Wang's result on her was outstanding and he is still alive, I followed the principle of not changing physicians when a treatment works, and encouraged her to trust him and continue under his care. I have since observed her for three more years; there is still no recurrence. I am therefore publishing her integrated TCM-Western case for reference by other ovarian cancer patients. Stage 3C ovarian cancer is already middle-to-late stage; surviving five years without recurrence proves her original integrated plan was highly successful.

The following text is provided entirely by the patient herself; the author has only edited and annotated it.

I. Clinical diagnosis: serous papillary cystadenocarcinoma of the ovary, stage 3C.

Date of surgery: July 1, 2010.

II. Postoperative pathology:

1. Adenocarcinoma infiltration in the left ovarian interstitium with cancer embolus found within vessels; slight adenocarcinoma infiltration in the fallopian tube wall; slight adenocarcinoma infiltration in the left parametrium.

2. Adenocarcinoma infiltration seen at the external cervical os.

3. No cancer involvement in the right parametrium.

4. Chronic cervicitis with nabothian cyst formation; the covering squamous epithelium shows CIN1–2 changes; koilocyte-like cells are seen.

5. Two 'right internal iliac' lymph nodes, one showing cancer metastasis; four 'left obturator' lymph nodes, one showing cancer metastasis; the remaining nodes show no metastasis.

6. Adenocarcinoma infiltration seen in the greater omentum.

III. Western chemotherapy:

Cisplatin 70–100 mg/m² (actual dose 120 mg); paclitaxel 135–175 mg/m² (actual dose 240 mg), given intravenously as six cycles of systemic chemotherapy.

IV. Most recent follow-up data:

1. Tumor markers on September 24, 2012:

Alpha-fetoprotein (AFP): 3.6 (reference range 0.00–20.00).

Carcinoembryonic antigen (CEA): 0.90 (reference range 0.00–5.00).

Carbohydrate antigen CA125: 5.10 (reference range 0.00–35.00).

Carbohydrate antigen CA199: 5.36 (reference range 0.00–37.00).

Compared with the previous tumor markers on June 5, 2012:

AFP: 1.0 (reference range 0.00–20.00).

CEA: 0.40 (reference range 0.00–5.00).

CA125: 5.20 (reference range 0.00–35.00).

CA199: 10.83 (reference range 0.00–37.00).

2. Imaging examination on March 9, 2012:

Contrast-enhanced CT of the whole abdomen: liver size and morphology normal, smooth hepatic margin, balanced lobar proportions, no obvious widening of the hepatic fissure, no obvious focal hepatic lesion. No obvious dilation of intra- or extrahepatic bile ducts. Gallbladder not enlarged, wall not thickened, no obvious abnormal enhancing density within. Spleen, pancreas, and bilateral adrenal glands normal in shape and size, no obvious abnormal enhancement. Both kidneys normal in shape, no obvious abnormal enhancement. No obviously enlarged enhancing retroperitoneal lymph nodes. Bladder well distended, wall not thickened, no obvious abnormal enhancing density within; uterus absent; no obvious abnormality in bilateral adnexal regions. Rectum patent, wall not thickened, no obvious abnormal enhancement. Pelvic fat spaces clear; no obviously enlarged bilateral inguinal lymph nodes; scanned bony structures show no obvious abnormality.

3. Most recent B-ultrasound, July 16, 2012:

No obvious solid mass at the vaginal cuff.

No obvious solid mass in the bladder mucosa or serosa.

No obvious solid mass in bilateral iliac-vessel regions.

No obvious dilation of bilateral renal pelves.

An anechoic pelvic area about 12 mm deep was detected.

Ultrasound impression: small amount of pelvic effusion. (Later resolved with herbal medicine.)

V. TCM treatment:

During hospitalization, after surgery my family went to invite Physician Wang to the hospital for a consultation. He said it was unnecessary and that I should wait until the first chemotherapy ended before starting decoctions, but he did write a 'formula.' My parents-in-law and husband carried two big bags of 'medicine' back to the hospital, saying it was prescribed by Physician Wang. When I looked, it turned out to be carrots and tomatoes. Ha. He told me to juice the carrots; I drank carrot juice for over half a year.

Initial visit: after the first chemotherapy ended (July 19, 2010), I began taking Physician Wang Taiyuan's herbal decoction.

Dangshen 15; Nüzhenzi 15; Buguzhi 12; Huangqi 30; Maidong 12; Taizishen 15; Huangjing 15; Lingzhi 15; Banzhilian 30; Baihua Sheshecao 30.

Second visit: original formula plus Sharen, Fuling, Dazao, Gancao.

The initial formula was used until the next visit on September 21, 2010; the formula was:

Huangqi 15; Huangjing 15; Dangshen 15; Danggui 12; Jixueteng 12; Nüzhenzi 15; Gouqizi 15; Taizishen 30; Chenpi 10; Baizhu 10; Fushen (Poriae Sclerotium Pararadicis) 12; Tusizi 15; Xianlingpi 10; Buguzhi 15; Dazao 6 pieces; Lingzhi 15.

Next visit, October 14, 2010:

Dangshen 10; Huangqi 10; Baizhu 10; Xianlingpi 10; Maidong and Tiandong each 10; Gouqizi 10; Mudanpi 10; Lujiao (Cervi Cornu) 10; Shengdi 10; Wuweizi 5; Fotu slices (Citri Sarcodactylis Fructus) 10; Sharen 6.

Next visit, October 28, 2010:

Huangqi 30; Huangjing 10; Taizishen 10; Danggui 10; Nüzhenzi 15; Jixueteng 15; Lujiao 15; Buguzhi 12; Baizhu 10; Dazao 6 pieces; Sharen 6.

Next visit, November 7, 2010:

Huangqi 12; Taizishen 12; Nüzhenzi 12; Baizhu 12; Fuling 12; Shanyao 12; Buguzhi 12; Lujiao 15; Danggui 10; Dazao 10 pieces.

Next visit, November 10, 2010:

Huangqi 30; Danggui 10; Dangshen 15; Ejiao 10; Lujiao 10; Nüzhenzi 15; Fuling 10; Chenpi 10; Buguzhi 15; Gancao 10; Dazao 10 pieces; Shengdi 15; Muli 30; Fuxiaomai (Tritici Levis Fructus) 30.

Next visit, December 8, 2010:

Huangqi 30; Taizishen 15; Baizhu 10; Fuling 12; Shanyao 12; Buguzhi 12; Lujiao 10; Gancao 10; Dazao 10 pieces; Nüzhenzi 15; Lingzhi 15.

Next visit, December 19, 2010: post-surgery qi deficiency.

Huangqi 15; Huangjing 15; Dangshen 12; Jixueteng 30; Danggui 10; Chenpi 10; Baizhu 12; Fuling 12; Tusizi 12; Buguzhi 10; Dazao 6 pieces; Gancao 6; Jiaoteng (Polygoni Multiflori Caulis) 30; Nüzhenzi 15.

Next visit, December 31, 2010: dual qi-yin deficiency.

Huangqi 15; Huangjing 15; Dangshen 15; Danggui 12; Baizhu 12; Tusizi 12; Nüzhenzi 15; Fushen 12; Fuxiaomai 30; Gancao 12; Dazao 10 pieces; Chenpi 10; Jiaoteng 30; Jixueteng 30; Muli 30.

Next visit, January 26, 2011:

Huangqi 15; Huangjing 15; Dangshen 15; Danggui 12; Baizhu 15; Fushen 12; Tusizi 15; Zhuling 30; Lingzhi 15; Banzhilian 15; Baihua Sheshecao 15.

Next visit, January 30, 2011: wind-heat rushing upward.

Sangye (Mori Folium) 10; Juhua (Chrysanthemi Flos) 10; Jiegeng (Platycodi Radix) 12; Lianqiao (Forsythiae Fructus) 15; Xingren 10; Bohe (Menthae Folium) 6; Zaoxiu (Paridis Rhizoma) 6; Dongguazi (Benincasae Semen) 12; Huoxiang 12; Lugen (Phragmitis Rhizoma) 15; Gancao 6.

Next visit, January 31, 2011:

Dangshen 15; Huangqi 30; Fuling 15; Baizhu 12; Chenpi 12; Shengma (Cimicifugae Rhizoma) 6; Chaihu 6; Zhuling 30; Lingzhi 15; Biandou (Dolichoris Album Semen) 12; Gancao 6; Dazao 6 pieces; Sangye 10; Heye (Nelumbinis Folium) 10.

[Jinhuang San 30, for external application, inflammatory enlargement of submandibular lymph nodes.]

Next visit, February 28, 2011: wind-heat rushing upward.

Sangye 10; Juhua 10; Jiegeng 10; Lianqiao 15; Xingren 10; Bohe 6; Lugen 15; Chuanbeimu (Fritillariae Cirrhosae Bulbus) 6; Huangqin 10; Qianhu (Peucedani Radix) 10; Dongguazi 12; Gancao 6.

Next visit, March 5, 2011: lung meridian ??

Sangye 10; Juhua 10; Jiegeng 10; Lianqiao 15; Bohe 6; Lugen 15; Zhizi 10; Dali (Arctii Fructus) 10; Baimaogen 15; Dongguazi 10; Gancao 6; Pugongying 30.

Next visit, March 19, 2011: rhinitis.

Sangye 10; Juhua 10; Jiegeng 10; Lianqiao 15; Xinyi (Magnoliae Flos) 10; Bohe 10; Mudanpi 10; Chishao 10; Cang'erzi (Xanthii Fructus) 10; Zhimu 10; Shigao 12; Gancao 12; Xiangfu 10; Chuan ?? 12.

After this, Physician Wang said I need not take herbal medicine for too long; I visited a few more times, but he wrote no more prescriptions.

I then went to a 'famous' TCM physician at a TCM hospital and kept taking his formulas:

1. Biejia (Trionycis Carapax) 30; Ezhu 10; Shengdi and Shudi each 20; Zaopi (Corni Fructus) 20; Maozhaocao 20; Yimucao (Leonuri Herba) 30; Huangqi 30; Baizhu 10; Yiyiren 30; Donglingcao (Isodis Herba) 30.

2. Chenpi 12; Zhuru (Bambusae Caulis in Taeniam) 6; Fuling 15; Zhigancao 6; Shanyao 15; Yiyiren 30; Zaopi 15; Xiakucao 18; Danxing (Arisaema cum Bile) 5.

In addition, an early-2011 B-ultrasound follow-up showed a small amount of pelvic effusion; after 10 doses of the following, it resolved.

Yinchen 15; Zhuling 15; Zexie 12; Fuling 15; Baizhu 12; Chenpi 10; Baishao 12; Cansha (Bombycis Faeces) 12; Danggui 12; Chaihu 10; Gancao 6; Xiangyuan (Citri Fructus) 10; Baihua Sheshecao 30.

And also:

Baizhu 12; Guizhi (Cinnamomi Ramulus) 10; Fuling 10; Zhuling 30; Zexie 15; Huangqi 15; Fangji (Stephaniae Tetrandrae Radix) 15; Yiyiren 30; Huaishan (Dioscoreae Rhizoma) 10; Baihua Sheshecao 30; Banzhilian 30; Lingzhi 30.