What Books to Read When Studying TCM Anti-Cancer Treatment

Modern TCM generally holds that cancer is a systemic disease manifesting locally as a tangible tumor. In the past, cancer was generally classified under sores, ulcers, carbuncles, and abscesses; by this classification it belongs to external-medicine (surgical) diseases.

Chen Shigong, the famous Ming-dynasty surgery expert and author of Waike Zhengzong (Orthodox Manual of External Medicine), wrote in his preface: "Medicine is divided into internal and external; treating the external is harder than treating the internal. Why? Internal ailments may not reach the exterior, but external ailments must root in the interior."

This means that TCM, broadly, is divided into internal and external medicine; treating external diseases is harder than treating internal ones. Why? Because internal diseases may not spread to the body surface, but external diseases must originate in internal conditions.

Chen Shigong's statement is apt. Modern medicine holds that cancer is caused by mutation of the human genome. Cancer is a disease involving both organic and functional lesions, so it is extremely difficult to treat.

A tumor occupies space within a normal organ; as it grows it inevitably impairs the organ's function. The body's qi and blood decline day by day, over time forming a huge tumor externally while internally causing deficiency of the patient's right qi. Caught between interior and exterior, the patient's life is gravely threatened, so treatment must address both.

Our renowned TCM scholar Professor He Ren (who himself was a cancer patient with a cancer history of several decades) summed up the essentials of TCM anti-cancer treatment in twelve characters: continuously support the right qi, expel pathogens at the right time, and treat according to the pattern.

Professor He Ren emphasized the importance of supporting right qi, requiring that right-supporting treatment run through the entire course for cancer patients. When the patient's condition permits, one should assess the timing and carry out pathogen-expelling treatment; the intensity of pathogen expelling must be adjusted at any time according to the patient's robustness. If too weak, the tumor is hard to contain; if too strong, the patient's right qi is easily damaged. When various complications arise, treat each symptomatically.

Professor He Ren's cancer-treatment philosophy is highly representative; contemporary TCM anti-cancer experts basically all adhere to these twelve characters.

Therefore, to learn TCM anti-cancer treatment, one must begin simultaneously with TCM internal and external medicine.

As for the foundational principles of TCM internal and external medicine, their root of course lies in the Huangdi Neijing. Reading the Neijing thoroughly and understanding the fundamental causes of human illness helps the physician treat tumors with clear aim.

I personally strongly oppose sectarian strife within TCM. Cancer patients, at every stage of the disease, can develop all sorts of bizarre symptoms; no single TCM school can handle them all. Whether the Jingfang (classical formula) school, the Warm-disease school, or the Jin-Yuan Four Great Masters, cancer is more often thorny than smooth.

So a person learning TCM cancer treatment should broaden their internal-medicine vision and not be bound to any school. The Shanghan Lun, Jingui Yaolue, Wenbing Tiaobian, and even the works of the Jin-Yuan Four Great Masters should be read repeatedly and pondered carefully. The more you learn and the more cases you witness, the more solutions you have in clinic and the better your results.

These foundational TCM works must be read repeatedly, and the classic famous formulas memorized. Professor Xiong Jibai said his teacher had hand-copied more than two thousand formulas himself and studied them over and over. I think this is an excellent learning method; studying TCM requires diligent, hard practice, taking many notes, and frequent review.

In treating complications of cancer patients, I have used formulas from the Shanghan Lun and Jingui Yaolue, formulas of the Warm-disease school, formulas of the Jin-Yuan Four Great Masters, and also many formulas from other medical works—for example, formulas from Wang Qishi's Lixu Yuanjian, Cheng Guopeng's Yixue Xinwu (Medical Heart-Mirror), and Wang Qingren's Yilin Gaicuo. When used appropriately, the formulas left by these physicians all have good efficacy.

But what I use most are still famous external-medicine formulas. I once briefly loved Jingfang and then the Warm-disease school, but after treating cancer I realized that specialization matters: cancer has, from ancient times to today, been assigned by most physicians to external medicine. If one treats cancer without studying external medicine, one has not found the gate.

TCM external medicine has three major schools: the Orthodox school (represented by Chen Shigong's Waike Zhengzong), the Quansheng school (represented by Wang Weide's Waike Zhengzhi Quansheng Ji), and the Xinde school (represented by Gao Bingjun's Yangke Xinde Ji).

Each of the three has its strengths; a student should closely read, even memorize, these three classic external-medicine works. The classic famous formulas left by these three schools remain the main force in TCM anti-cancer treatment today. In clinical practice there should be no sectarian prejudice; one may choose the appropriate therapeutic approach according to the patient's specific condition.

Besides these three schools, there are other classic works of TCM external medicine worth reading, such as Qi Dezhi's Waike Jingyi (Yuan dynasty), Xue Lizhai's Waike Fahui (Ming), Qi Kun's Waike Dacheng (Qing), and Chen Zhengong's Dongtian Aozhi (Qing). These physicians were all great clinicians with rich learning and experience; their clinical experience is precious.

The greatest internal-medicine feature of cancer is that it greatly consumes the patient's original qi; cancer patients mostly have qi and blood deficiency. So treating cancer also requires special attention to the experience of ancient and modern TCM in treating deficiency-damage diseases.

Historically, the most famous physician for deficiency-damage was the Ming-dynasty Wang Qishi, whose representative work is Lixu Yuanjian. Wang Qishi can be called the synthesizer of treating deficiency-damage. Earlier physicians emphasized either tonifying the kidney or fortifying the spleen, or both equally; Wang Qishi emphasized that in deficiency-damage the three organs—lung, spleen, and kidney—must be treated equally.

The reason I specially mention Wang Qishi is that many contemporary TCM physicians are trapped in sectarian strife and prescribe with bias: some like using large amounts of kidney-tonifying herbs, some large amounts of spleen-fortifying herbs, some large amounts of yin-nourishing herbs, all inevitably leading to over-supplementation that harms the patient's quality of life. Wang Qishi's approach of simultaneously tonifying lung, spleen, and kidney precisely grasps the root of cancer patients' deficiency.

Our renowned modern TCM scholar Shi Jinmo expanded TCM's eight-principle pattern differentiation (exterior/interior, yin/yang, cold/heat, deficiency/excess) into ten principles, adding qi and blood. This addition of qi and blood is indeed a problem common to cancer patients. As cancer progresses, most patients show qi deficiency and blood insufficiency, insecurity of defensive yang, and insufficiency of nutritive blood and fluids. So in treating cancer patients' deficiency, the first priority is qi and blood.

Other great physicians of deficiency-damage include Zhou Shenzhai and Hu Shenrou; the former wrote Shenzhai Quanshu and the latter Shenrou Wu Shu. Xue Lizhai and Li Dongyuan were also great clinicians skilled in deficiency diseases, especially the Ming-dynasty Xue Lizhai, a clinician versed in both internal and external medicine with extremely rich experience treating carbuncles, ulcers, and sores; reading his works is very inspiring.

Personally, I think cancer treatment can be summed up in eight characters: internally treat deficiency-damage; externally dispel the tumor. So a person learning TCM cancer treatment must always remember to work on these two aspects.

The main TCM method for dispelling tumors is still using poison to attack poison. In this regard, our contemporary great anti-cancer physician Sun Bingyan is a rare master. In clinical cancer treatment, Dr. Sun often combined several or even dozens of poison-attacking-poison herbs. Generally, poison-attacking herbs should be made into patent preparations for patients, so that dosage can be controlled relatively safely.

The greatest risk of using poison to attack poison is the patient overdosing on the toxin and being poisoned to death. When using poison-attacking-poison treatment, Sun Bingyan placed great emphasis on the precipitating/purging method, which ensures the toxin does not accumulate in the body for too long.

Zhang Zihe, author of Rumen Shiqin (A Confucian's Duties to Physicians), was a master of the precipitating-purging method and a physician greatly admired by Sun Bingyan. Zhang Zihe was one of the Jin-Yuan Four Great Masters; those learning TCM anti-cancer treatment should understand his main medical thought and methods.

Once you are familiar with the scholarly thought of these physicians, read more clinical case records of cancer treatment through the dynasties, keep a Bencao compendium like the Zhonghua Bencao or Zhongyao Da Cidian at hand, keep learning, and keep practicing; over time the basic approach of TCM cancer treatment will become clear in your mind.

The above works take roughly ten years of effort to read through and digest. To refine one's skill further, one must also widely read the medical works of great clinicians to broaden one's horizons.

Objectively speaking, the cure rate of TCM for cancer is also low. But if a TCM physician can read widely, be careful and diligent in clinical work, maintain good communication with patients, keep track of each treated patient's specific condition, and adjust prescriptions as the patient's body changes, then although such treatment cannot cure the cancer, it will certainly prolong the patient's life. When doctor and patient have a close relationship and cooperate well, some patients can achieve long-term survival with the tumor.