TCM, Herbal Medicine and Cancer

TCM, Herbal Medicine and Cancer

In China the reception hall of a Traditional Chinese Medicine (TCM) hospital is a fascinating place. Behind a long counter there are hundreds of drawers, often housed in a number of giant timber chests, each containing an individual dried herb or medicinal substance. Patients come from the different departments of the hospital and present a script from their consultant doctor which is then made up in the dispensary, with each herb individually weighed, combined with other herbs from the script, and placed in paper bags.

One of the departments in the hospital is typically the oncology department. In China it is considered entirely realistic and beneficial to combine TCM medicinals with Western biomedical treatment in the hospital setting.

The Japanese take this a step further, with individual oncologists granted a remarkable amount of autonomy and freedom in the treatments that they can offer; many of them subscribe to the benefits of herbal medicine, and Japanese herbal medicine is founded on the classical texts that underpin TCM.

Chinese herbal formulas are constructed according to an organising principle involving a hierarchy of ingredients. The Chief herb treats the primary disease and tends to be prescribed in the biggest dose. The Deputy helps the Chief and is often chosen to treat co-existing disease patterns. The Assistant reinforces the actions of the Chief and Deputy, and can modulate the harsh properties or side effects of them, for example an Assistant might protect digestion when the Chief is a powerful anti-bacterial herb that might harm the gut biome. Finally, the Envoy focuses the formula on a particular part of the body and harmonises and integrates the action of the other herbs. Using this principle of construction a herbal formula can be as simple of one herb, a stand alone Chief, though this is rare; in modern herbal medicine formulas typically have between 10 and 30 ingredients and can have more than one Chief, giving the formulas versatility, potency and lots of opportunities for synergism between the herbs.

These days scientific research has identified a number of herbs that have empirical anti-cancer effects, so in most cases a herbalist will try to include a significant number of herbs in the formula that not only fulfil the TCM treatment principles but also aim to help to diminish or eliminate the tumours.

My herbal dispensary has over 400 herbs in it, and if I need a rarely used herb to treat a particular condition I simply order it in. The TCM hospital dispensary will have hundreds more. Hence with so many herbs and possible combinations of herbs, the needs of the individual at different stages of disease, with different emotional traumas and digestive status can be accommodated.

As a guide to the construction of the herbal treatments TCM theory is a powerful resource when it comes to cancer. The first evidence of the recognition of cancer in Chinese Medicine is from nearly 4000 years ago with the differentiation of different types of cancer in ancient texts. A huge oncological literature has built since.

Today types of cancer are broadly broken down in to 4 types - Stagnation of Qi, Blood Stasis, Phlegm accumulation and Fire toxins with 4 more underlying deficiencies of Qi, Blood, Yin and Yang.

Please note that these references are not literal as we would use them in every day English, rather they are translations of Chinese Medical terms and should only be used within the TCM medical concept, rather than conflating them with the common use of these words in English. For example, in TCM there are a number of different manifestations of “Phlegm”, not all of them are obviously tangible as snot!

So there is a danger of misinterpretation by depicting in English the 4 types of cancer and 4 types of deficiency in an article like this. But, in my view, this danger is outweighed by the value of understanding that these concepts are applied by the TCM practitioner to the individual, as they are seen to occur, to construct comprehensive diagnosis and treatment, with the result that TCM can be used to explain the conundrum that continually baffles oncologists - “why do two people with the same cancer respond the the same treatment in different ways?”.

In TCM the answer to this question is simple: because all cancer is different in different people and in TCM we have diagnostic methods to identify these differences.

So if a TCM practitioner is approached to help with treating cancer the aim of the treatment is two fold, to aim to treat the cancer itself (typically alongside Western medical treatment) through eliminating Fire poison, moving and circulating Qi and Blood and/or resolving Phlegm, and also supporting the individual through strengthening their essential strength (zheng qi), whether it be the strengthening their Qi, Blood, Yin or Yang.

An analogy can be made with horticulture - an effective gardener will remove a weed without poisoning the soil in which the weeds are growing; at the same time the gardener will nourish the soil so that beautiful flowers can grow tall to outcompete the weeds.

As I previously mentioned, as more and more scientific research is conducted on the anti-cancer properties of Chinese herbs, then increasingly TCM formulas tend to be reinforced by the understanding that many of the ingredients have been demonstrated scientifically to have anti- cancer effects.

Here are some examples of herbs that have been shown to have empirical anti-cancer effects in the lab and beyond according to their categories of TCM action:

Move Blood - Radix Notoginseng (San Qi) is Cytotoxic, promotes apoptosis, anti proliferative and immune enhancing. Other herbs include Rhizoma Curcumae Longae (Jiang Huang), Rhizoma Curucumae (E Zhu) and Radix Salviae Miltiorrhizae (Dan Shen).

Resolve Phlegm - Spica Prunellae (Xia Ku Cao) is anti oestrogenic, inhibits tumour growth and promotes apoptosis. Other herbs include Thallus Luminariae seu Eckloniae (Kun Bu, Kelp).

Eliminate Fire Poison - Radix Lithospermi (Zi Cao) is pro-apoptosis and anti-proliferative. Other herbs include Herba Violae (Zi Hua Di Ding), Herba Taraxaci (Pu Gong Ying) and Herba Oldenlandia (Bai Hua She She Cao).

Move Stagnant Qi - Pericarpium Citri Reticulatae Viride (Qing Pi) is pro-apoptosis. Other herbs include Radix Bupleuri (Chai Hu) and Radix Peoniae Alba (Bai Shao).

Invigorate and Strengthen Qi - Ganoderma (Ling Zhi) is immune regulating and promotes apoptosis. Other herbs include Radix Astragali (Huang Qi), Radix Ginseng (Ren Shen) and Radix Rhodiola (Hong Jing Tian).

In addition many herbs have actions over more than one category such as Retinervus Luffae Fructus (Si Gua Luo) and Cortex Magnoliae Officinalis (Hou Po) which can make them particularly useful ingredients in an elegant and effective formula.

The consequence of the wide range of herbal actions, combined with the many hundreds of herbs available to the practitioner is that Chinese herbal medicine is suitably versatile for helping cancer patients and beyond.

This great herbal medicine is a truly remarkable resource.

Chinese medicine and cancer
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