Thursday, July 7, 2011

Chinese Herbs for Cancer

©2007 Narda G. Robinson, DO, DVM, MS. All rights reserved.

Chinese herbalists have been medicating patients with tumors for over two thousand years. 1 In stark contrast to Western oncology concepts that undergo constant revision, Chinese medical ideas about tumor pathogenesis and herbal responses have remained largely the same over the centuries.2 Still, though, Traditional Chinese Medical (TCM) approaches hold strong attraction for human oncology patients and people whose animals have cancer.3 TCM practitioners shun the image of “waging war on cancer” and instead embrace the more peaceful and organic view of cancer as a journey, regarding the patient not as a battlefield but as a garden to be nurtured.4 5 6
The enormous draw of Chinese medicine and other traditional medicine practices led the World Health Organization to consider ways to best study the effectiveness and safe implementation of CAM methods in clinical practice. Inresponse, they formulated the Traditional Medicine Strategy 2002-2005.7 In thesame year, the White House Commission published a Complementary and Alternative Medicine Policy.8 Both organizations urged researchers to
investigate the claims and practices of long-held belief systems and empirically derived treatments. The National Cancer Institute now recognizes that following the leads laid by longstanding tradition will generate higher yields thansearching for cancer-fighting botanicals de novo.9 Even the Chinese Society of Traditional Veterinary Science in Taiwan and the Asian Society of Traditional Veterinary Science have sounded calls for more research and education in
Traditional Chinese Veterinary Medicine (TCVM) and, specifically, in herbalprescribing.10
The assortment of Chinese herbal treatments being promoted for animal patients with cancer is growing. Testimonials asserting reductions in tumor size in dogs who received Chinese herbs further stoke enthusiasm and hopes of finding analternative cure.11 12 13 However, rather than basing the herbal prescription ontumor type or biopsy results, herbs are matched to a patient’s disease “pattern”,which sorts patients into groups according a system based on visible signs on
the body, the specifics of which are unique to TCM.14 TCM holds that tumors and cancer arise from emotional stress, overwork, poornutrition, invasion of pathogens, and poor circulation.15 16 Of these, impairedcirculation ranks as perhaps the most strongly linked etiologic factors leading tocancer and metastasis.17 18 From a Chinese medicine perspective, the poor circulation associated with the “blood stasis” pattern will not only deprive tissue ofvital oxygen, absorbed nutrients, and immune surveillance, and it also leads to the buildup of metabolic end-products in the tissues. Modern oncology resonateswith this perspective at least in part, acknowledging that the microcirculation within tumors can be abnormal and contain areas of sluggish perfusion.
Furthermore, some researchers have added anticoagulants to chemotherapy
agents in order to lengthen survival and prevent blood-borne metastasis.19
Others have found that elevating oxygen tension increases the radiosensitivity of
tumors.20
Many of the Chinese herbs found in traditional remedies for tumors (whether benign or malignant) promote blood flow, in order to “soften and disperse” the tumor and the stagnant blood and toxins residing within it.21 22 23 In the “blood stasis” (i.e., poor circulation) pattern commonly found in patients with cancer, the clinical picture includes stabbing pain, a purple tongue, dark complexion, tumor(s) and ecchymoses or petechiae.24
Although finding a purple tongue in a dog may at first seem to indicate nothing more than some Chow Chow ancestry, researchers have linked certain tongue appearances to certain disease states such as cancer.25 As one researcher put it, “The tongue is a mirror reflecting the activity of the interior of the human body. The morbid conditions of viscera and bowels emerge as the alternations of the tongue so that visual inspection enables one to grasp the state of the inside of
the body.”26 Not all patients with cancer will exhibit a “blood-stasis” pattern, and patients with
different TCM patterns may require other herbs, according to the TCM paradigm.27 28 For example, a canine patient with a fibrosarcoma who pants, acts restless, feels warm, has a bright red complexion, rapid pulse and a red, dry tongue may be receive the TCM “diagnosis” of Excess Heat, a markedly different presentation from blood stasis. Based on this determination, a “hot” dog might receive herbs that “nourish Yin” and “clear heat”, such as Scrophularia ningpoensis and Scutellaria baicalensis, in contrast to the “blood moving” herbs prescribed for patients with “blood stasis”. 29 Interestingly, both herbs display significant anti-angiogenic activity.30 Other metaphorical categories applied to cancer patients include “yin deficiency”, “qi deficiency”, and “meridian obstruction”.31
At this point in our understanding, hundreds of thousands32 of human TCM practitioners around the globe continue to employ ancient metaphors in the diagnosis and treatment of cancer.33 However, none of these approaches has been systematically tested to ascertain either the reliability of the methods between examiners or the correlation between TCM and Western medical diagnoses.34 To make matters worse, the degree of diagnostic consistency exhibited by TCM practitioners in terms of pattern differentiation has been typically low.35 36 That is, the patterns assigned to patients frequently vary from one practitioner to the other as will the herbal prescriptions, since one leads to the other.
The question naturally arises whether the herbs themselves offer intrinsic benefits whether or not they match the patient’s individual TCM pattern. It may be that the anti-cancer benefits of ten to twelve herbs given in combination would work as well for a patient determined to have cancer as a result of blood stasis or Excess Heat. A number of Chinese botanicals display anti-cancer activity and may be beneficial for a broad array of cancer patients, no matter what their TCM pattern indicates.37 38 Herbs such as astragalus and angelica activate the immune system and display antitumor activity. 39 Others, like Oldenlandia diffusa, encourage apoptosis. 40 A meta-analysis evaluated the evidence from randomized trials concerning the combination of astragalus-containing Chinese herbal products with platinum-based chemotherapy. The literature analysis revealed improved survival, tumor response, and diminished toxicity as a result of the combination.41
Chinese herbal combinations usually include 8-20 plant and/or animal products. This creates obstacles in sorting out which plants or animal compounds actually confer benefits, which cause synergistic or negative herb-drug interactions, and which might raise toxicity.42 Added concerns surround the inclusion of mammal, reptile, sea creature, or insect parts, as well as substances obtained illegally from endangered wildlife. Lastly, the ongoing discovery of intentional pharmaceutical adulterants and unintentional contaminants in Chinese herbs puts yet one more
hurdle in place for those considering Chinese herbs for cancer patients.


1 Xie H. How to select Chinese herbal medicine for cancer patients. American Journal of Traditional
Chinese Veterinary Medicine. 2006;1(1):49-52.
2 Xu W, Towers AD, Li P, et al. Traditional Chinese medicine in cancer care: perspectives and
experiences of patients and professionals in China. European Journal of Cancer Care. 2006;15:397-403.
3 Wong R, Sagar CM, and Sagar SM. Integration of Chinese medicine into supportive cancer care: a
modern role for an ancient tradition. Cancer Treatment Reviews. 2001;27:235-246.
4 Reisfield GM and Wilson GR. Use of metaphor in the discourse on cancer. Journal of Clinical
Oncology. 2004;22(19):4024-4027.
5 Penson RT, Schapira L, Daniels KJ, et al. Cancer as metaphor. The Oncologist. 2004;9:708-716.
6 Xu W, Towers AD, Li P, et al. Traditional Chinese medicine in cancer care: perspectives and
experiences of patients and professionals in China. European Journal of Cancer Care. 2006;15:397-403.
7 World Health Organization (online 202) WHO Traditional Medicine Strategy 2002-2005. Obtained at
http://whqlibdoc.who.int/hq/2002/WHO_EDM_TRM_2002.1.pdf on 03-15-07.
8 White House Commission on Complementary and Alternative Medicine Policy, 2002. Obtained at
http://www.whccamp.hhs.gov/finalreport_pdf.html on 03-15-07.
9 Cragg GM, Boyd MR, Cardellina JH, et al. Ethnobotany and drug discovery: the experience of the US
National Cancer Institute. 1994 Ethnobotany and the search for new drugs. Wiley, Chichester (Ciba
Foundation Symposium 185), pp. 178-196.
10 Kaphle K, Wu L-S, Yang N-YJ, et al. Herbal medicine research in Taiwan. eCAM. 2006;3(1):149-155.
11 Xie H. How to select Chinese herbal medicine for cancer patients. American Journal of Traditional
Chinese Veterinary Medicine. 2006;1(1):49-52.
12 Kaphle K, Wu L-S, Yang N-Y J, and Lin J-H. Herbal medicine research in Taiwan. eCAM.
2006;3(1):149-155.
13 Lana SE, Kogan LR, Crump KA, Graham JT, and Robinson NG. The use of complementary and
alternative therapies in dogs and cats with cancer. J Am Anim Hosp Assoc. 2006;42:361-365.
14 American Cancer Society. Guide to Complementary and Alternative Cancer Methods. 2000. P. 196.
15 Xie H. How to select Chinese herbal medicine for cancer patients. American Journal of Traditional
Chinese Veterinary Medicine. 2006;1(1):49-52.
16 Wong R, Sagar CM, and Sagar SM. Integration of Chinese medicine into supportive cancer care: a
modern role for an ancient tradition. Cancer Treatment Reviews. 2001;27:235-246.
17 Wong R, Sagar CM, and Sagar SM. Integration of Chinese medicine into supportive cancer care: a
modern role for an ancient tradition. Cancer Treatment Reviews. 2001;27:235-246.
18 Xiu HM and Liu JX. Advances in TCM treatment for metastasis of tumors. Journal of Traditional
Chinese Medicine. 2003;23(2):151-157.
19 Wong R, Sagar CM, and Sagar SM. Integration of Chinese medicine into supportive cancer care: a
modern role for an ancient tradition. Cancer Treatment Reviews. 2001;27:235-246.
20 Wong R, Sagar CM, and Sagar SM. Integration of Chinese medicine into supportive cancer care: a
modern role for an ancient tradition. Cancer Treatment Reviews. 2001;27:235-246.
21 Wong R, Sagar CM, and Sagar SM. Integration of Chinese medicine into supportive cancer care: a
modern role for an ancient tradition. Cancer Treatment Reviews. 2001;27:235-246.
22 Sang H and Wu B. Clinical and experimental research into treatment of hysteromyoma with promoting
qi flow and blood circulation, softening and resolving hard lump. Journal of Traditional Chinese
Medicine. 2004;24(4):274-279.
23 Marsden S, Messonnier S, and Yuill C. Traditional Chinese Medicine. Obtained at
http://www.lifelearn.com/c3/Veterinary%20TCM.pdf on 02-17-07.
24 Jiang W-Y. Therapeutic wisdom in traditional Chinese medicine: a perspective from modern science.
TRENDS in Pharmacological Sciences. 2005;26(11):558-563.
25 Cohen I, Tagliaferri M, and Tripathy D. Traditional Chinese Medicine in the treatment of breast cancer.
Seminars in Oncology. 2002;29(6):563-574.
26 Takeichi M and Sato T. Studies on the psychosomatic functioning of ill-health according to Eastern and
Western Medicine 1. Visual observation of the sublingual vein for early detection of vital energy
stagnation and blood stasis. American Journal of Chinese Medicine. 1999;27(1):43-51.
27 Wang JF, Cai CZ, Kong CY, et al. A computer method for validating Traditional Chinese Medicine
herbal prescriptions. American Journal of Chinese Medicine. 2005;33(2):281-297.
28 Wang JF, Cai CZ, Kong CY, et al. A computer method for validating Traditional Chinese Medicine
herbal prescriptions. American Journal of Chinese Medicine. 2005;33(2):281-297.
29 Xie H. How to select Chinese herbal medicine for cancer patients. American Journal of Traditional
Chinese Veterinary Medicine. 2006;1(1):49-52.
30 Wang S, Zheng Z, Weng Y, et al. Angiogenesis and anti-angiogenesis activity of Chinese medicinal
herbal extracts. Life Sciences. 2004;74:2467-2478.
31 Zhang T, Ma S-L, Xie G-R, et al. Clinical research on nourishing Yin and unblocking meridians recipe
combined with opioid analgesics in cancer pain management. Chin J Integr Med. 2006;12(3):180-184.
32 Deng W-P, Chao M-W, Lai W-F, et al. Correction of malignant behavior of tumor cells by traditional
Chinese herb medicine through a restoration of p53. Cancer Letters. 2006;233:315-327.
33 Wong WCW, Lee A, Wong SYS, et al. Strengths, weaknesses, and development of Traditional Chinese
Medicine in the health system of Hong Kong: through the eyes of future Western doctors. Journal of
Alternative and Complementary Medicine. 2006;12(2):185-189.
34 Coyle M and Smith C. A survey comparing TCM diagnosis, health status and medical diagnosis in
women undergoing assisted reproduction. Acupuncture in Medicine. 2005;23(2):62-69.
35 Zhang GG, Lee W, Bausell B, et al. Variability in the Traditional Chinese Medicine TCM) diagnoses
and herbal prescriptions provided by three TCM practitioners for 40 patients with rheumatoid arthritis.
Journal of Alternative and Complementary Medicine. 2005;11(3):415-421.
36 Zhang GG, Bausell B, Lao L, et al. The variability of TCM pattern diagnosis and herbal prescription on
rheumatoid arthritis patients. Alternative Therapies. 2004;10(1):58-63.
37 Wynn SG and Fougere BJ. Veterinary Herbal Medicine. St. Louis: Mosby, Inc. 2007. P. 308.
38 Xie H. How to select Chinese herbal medicine for cancer patients. American Journal of Traditional
Chinese Veterinary Medicine. 2006;1(1):49-52.
39 Wong R, Sagar CM, and Sagar SM. Integration of Chinese medicine into supportive cancer care: a
modern role for an ancient tradition. Cancer Treatment Reviews. 2001;27:235-246.
40 Yadav, SK and Lee SC. Evidence for Oldenlandia diffusa-evoked cancer cell apoptosis through
superoxide burst and capsase activation. Journal of Chinese Integrative Meidcine. 2006;4(5):485-489.
41 McCulloch M, See C, Shu X-J, et al. Astragalus-based Chinese herbs and platinum-based chemotherapy
for advanced non-small-cell lung cancer: meta-analysis of randomized trials. Journal of Clinical
Oncology. 2006;24(3):419-430.
42 Meijerman I, Beijnen JH, and Schellens JHM. Herb-drug interactions in oncology: focus on
mechanisms of induction. Oncologist. 2006;11:724-752.

2 comments:

  1. Hello,
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    Thanks,
    David

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  2. I recently came across your blog and have been reading along. I thought I would leave my first comment. I don't know what to say except that I have enjoyed reading. Nice blog. I will keep visiting this blog very often.


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