CANCER HERBS CLASSIFIED ACCORDING TO PATTERN
STASIS OF BLOOD
Ru Xiang Gummi Olibanum, Mo Yao Myrrha, San Leng Rhizoma Sparganii stoloniferi, E Zhu Rhizoma Curcumae Ezhu, Di Bie Chong Eupolyphaga, Wang Bu Liu Xing Semen Vaccariae segetalis, Ze Lan Herba Lycopi lucidi.
PHLEGM
Hai Ge Ke Concha Cyclinae, Tian Nan Xing Rhizoma Arisaematis, Shan Jia Squama Manitis Pentadactylae, Ting Li Zi Semen Descurainiae seu Lepidii, Bai Jie Zi Semen Sinapsis albae, Fu Ling Poria, Yi Yi Ren Semen Coicis Lachryma-Jobi, Zhe Bei Mu Bulbus Fritillariae thunbergii, Gua Lou Fructus Trichosanthis, She Gan Rhizoma Belamcandae chinensis, Huang Yao Zi Rhizoma Dioscoreae bulbiferae.
TOXIC HEAT
He Huan Pi Cortex Albizziae julibrissin, Bai Hua She She Cao Herba Hedyotis diffusae, Ban Zhi Lian Herba Scutellariae barbatae, Tu Fu Ling Rhizoma Smilacis glabrae, Fu Ling Poria, Shan Dou Gen Radix Sophorae Tonckinensis, Xia Ku Cao Spica Prunellae vulgaris, Da Qing Ye Folium Isatidis, Ku Shen Radix Sophorae Flavescentis.
DAMPNESS
Sha Ren Fructus Amomi, Mu Xiang Radix Aucklandiae Lappae, Ze Xie Rhizoma Alismatis orientalis, Xiang Fu Rhizoma Cyperi rotundi, Fo Shou Fructus Citri sarcodactylis, Tu Fu Ling Rhizoma Smilacis glabrae, Shan Zha Fructus Crataegi, Shen Qu Massa Medica Fermentata, Zhi Ke Fructus Citri aurantii, Zhi Shi Fructus immaturus Citri aurantii, Bian Dou Semen Dolichoris Lablab, Pei Lan Herba Eupatorii, Gui Zhi Ramulus Cinnamomi cassiae.
XU
Qi: Ren Shen Radix Ginseng, Tai Zi Shen Radix Pseudostellariae, Da Zao Fructus Jujubae, Huang Qi Radix Astragali membranacei, Bai Zhu Rhizoma Atractylodis macrocephalae.
Blood: Shou Wu Radix Polygoni multiflori, E Jiao Gelatinum Corii Asini, Long Yan Rou Arillus Euphoriae Longanae, Sang Ji Sheng Ramulus Loranthi, Gou Qi Zi Fructus Lycii.
Yang: Yin Yang Huo Herba Epimedii, Lu Jiao Cornu Cervi, Ba Ji Tian Radix Morindae officinalis, Bu Gu Zhi Fructus Psoraleae corylifoliae, Rou Cong Rong Herba Cistanches deserticolae, Hu Tao Ren Semen Juglandis regiae.
Yin: Sha Shen Radix Adenophorae seu Glehniae, Tian Men Dong Tuber Asparagi cochinchinensis, Shi Hu Herba Dendrobii, Yu Zhu Rhizoma Polygonati odorati, Bai He Bulbus Lilii, Nu Zhen Zi Fructus Ligustri lucidi, Gou Qi Zi Fructus Lycii, Han Lian Cao Herba Ecliptae prostratae, Bie Jia Carapax Amydae sinensis, Wu Wei Zi Fructus Schisandrae chinensis, Ling Zhi Fructificatio Ganodermae.
SOFTENING HERBS
Mu Li Concha Ostreae, Shan Jia Squama Manitis Pentadactylae, Hai Zao Herba Sargassii, Kun Bu Thallus Laminariae seu Eckloniae, Jiang Can Bombyx Batryticatus, Gui Ban Plastrum Testudinis, Bie Jia Carapax Amydae sinensis, Wa Leng Zi Concha Arcae, Ku Shen Radix Sophorae flavescentis, Wu Gong Scolopendra Subspinipes, Yi Yi Ren Semen Coicis Lachryma-Jobi.
“Softening” herbs are used in case of masses which may be from Blood stasis, Phlegm or a combination of both. The “softening” herbs soften the mass so that it is more easily treated.
Note how the softening herbs are in different categories and we would choose those from a category of herbs treating the presenting pattern.
For example, if the mass was from Blood stasis we would choose Shan Jia Squama Manitis Pentadactylae; on the other hand, if the patient has a background of Yin deficiency, we would choose Mu Li Concha Ostreae, Gui Ban Plastrum Testudinis, or Bie Jia Carapax Amydae sinensis.
I list below some herbs that have a particular anti-cancer effect according to modern research.
HERBS WITH ANTI-CANCER EFFECT
SHI JIAN CHUAN Herba Salviae chinensis
(Other name: Xiao Dan Shen)
Taste: energy: bitter, pungent, neutral
Actions: Clear Heat, resolve Phlegm, move Blood, stop pain.
Indications: Chronic hepatitis, hypochondriac pain, cancer of oesophagus.
HUANG YAO ZI Rhizoma Dioscoreae bulbiferae
Taste, energy: Bitter, pungent, slightly toxic
Channel: HE, LIV
Actions: Dissolve swelling, eliminate Toxin, stop cough, calm asthma, cool Blood, stop bleeding.
Indications: Goiter, scrofula, cough, asthma, cancer of oesophagus, whooping cough, vomiting of blood, epistaxis.
BAN ZHI LIAN Herba Scutellariae barbatae
Taste, energy: bitter, cold
Channel: LIV, ST, LU
Actions: Clear Heat, resolve Toxin, scatter stasis, stop bleeding, benefit urination, resolve cancer.
Indications: Cancer of lungs, liver, intestines, uterus, stomach, appendicitis, hardening of liver, carbuncles, pus, lung abscess, epistaxis, haematemesis, haematuria.
Contraindications: Not in pregnancy
BAN BIAN LIAN Herba Lobeliae chinensis
Taste, energy: pungent, cold
Channel: LIV,KI,LU
Actions: Clear Heat, resolve poison, benefit urination, resolve swelling.
Indications: Sores, acne, swelling, hardening of liver, ascites, kidney-oedema, cancer of liver, intestines, stomach.
SAN BAI CAO Herba Saururi chinensis
Taste, energy: Sweet, pungent, cold
Channel : LIV, GB
Actions: Clear Heat, resolve Toxin, benefit urination, resolve swelling.
Indications: Oedema, cancer of liver, jaundice.
WEI LING XIAN Herba Clematidis chinensis
Taste, energy: Pungent, warm
Channel: BL
Actions: Expel Wind, resolve Dampness, penetrate channels, stop pain, resolve inflammation, scatter accumulation.
Indications: Bi syndrome, cancer of breast, larynx, numbness of legs.
SHAN DOU GEN Radix Sophorae subprostratae
Taste, energy: Bitter, cold
Channel: HE, LU, L.I.
Actions: Clear Heat, resolve Toxin, reduce swelling, stop pain.
Indications: Throat swelling, tonsillitis, cancer of lungs, stomach, bladder, uterus, leukemia.
SAN LENG Rhizoma Sparganii stoloniferi
Taste and energy: bitter, neutral
Channels:LIV, SP.
Actions: Break up Blood, eliminate Blood stasis, move Qi, stop pain.
LOU LU Radix Rhapontici seu Echinopsis
Taste and energy: bitter, cold
Channels: Stomach
Actions: Clear Heat, expel Toxin.
Indications: abscess, oedema, lactation problems.
TIAN KUI ZI Radix Semiaquilegiae
Taste and energy: bitter, cold
Channels: BL, KI.
Actions: expel Toxin
Indications: oedema
TENG LI GEN Radix Actinidiae argutae
Taste and energy: bitter, cold
Channels: LU, LIV, ST, SP and LI
Actions: resolve Toxin, clear Heat, eliminate stasis
Indications: cancer.
TENG LI GEN Radix Actinidiae argutae
Taste and energy: bitter, cold
Channels: LU, LIV, ST, SP and LI
Actions: resolve Toxin, clear Heat, eliminate stasis
Indications: cancer.
SHI SHANG BAI Herba Selaginellae
Taste and energy: bitter, pungent, cold
Channels: LIV, LU, ST.
Actions: clear Heat, resolve Toxin resolve Damp-Heat.
Indications: cough, jaundice, liver cancer, hepatitis, cirrhosis of liver.
TING LI ZI Semen Descurainiae seu Lepidii
Taste and energy: bitter, pungent, cold
Channels: Lungs and Bladder
Actions: clear Heat, resolve Phlegm
Indications: breathlessness, oedema, urinary retention.
Caution: it is a harsh cathartic.
DI BIE CHONG Eupolyphaga
Taste and energy: salty, cold
Channels: Liver
Actions: break up Blood, eliminate Stasis
Indications: Liver cancer
SHUI ZHI Hirudo
Taste and energy: salty, bitter, neutral
Channels: Liver
Actions: break up Blood, eliminate stasis
Indications:
BAN MAO Mylabris
Taste and energy: pungent, cold
Channels: Small Intestine, Large Intestine, Liver
Actions: expel Toxin, invigorate Blood
Indications:
Lastly, I list below the same herbs listed above but classified according to organ affected.
CANCER HERBS ACCORDING TO ORGAN
OESOPHAGUS
Shi Jian Chuan Herba Salviae chinensis, Huang Yao Zi Rhizoma Dioscoreae bulbiferae, Shi Da Chuan
STOMACH
Bai Hua She She Cao Herba Hedyotis diffusae, Ban Zhi Lian Herba Scutellariae barbatae, Ban Bian Lian Herba Lobeliae chinensis.
INTESTINES
Ku Shen Radix Sophorae flavescentis, Ban Zhi Lian Herba Scutellariae barbatae, Ban Bian Lian Herba Lobeliae chinensis, Bai Hua She She Cao Herba Hedyotis diffusae.
LIVER
Long Dan Cao Radix Gentianae scabrae, Ban Lan Gen Radix Isatidis, Ban Zhi Lian Herba Scutellariae barbatae.
NOSE PHARYNX
Xia Ku Cao Spica Prunellae vulgaris, Shi Shang Bai Herba Selaginellae, Kun Bu Thallus Laminariae seu Eckloniae, Gua Lou Pi Pericarpium Trichosanthis, Hai Zao Herba Sargassii.
BREAST
Pu Gong Ying Herba Taraxaci, Ban Bian Lian Herba Lobeliae chinensis, Tian Men Dong Tuber Asparagi cochinchinensis, Wei Ling Xian Radix Clematidis, Wang Bu Liu Xing Semen Vaccariae segetalis.
UTERUS
E Zhu Rhizoma Curcumae Ezhu, Lou Lu Radix Rhapontici seu Echinopsis, Zi Cao Radix Arnebiae seu Lithospermi.
LARYNX
Shan Dou Gen Radix Sophorae subprostratae, Gua Lou Pi Pericarpium Trichosanthis, Wei Ling Xian Radix Clematidis.
LIPS
Liang Ge San (Prescription) Cooling the Diaphragm Powder (Lian Qiao, Zhu Ye, Da Huang, Mang Xiao, Gan Cao, Bo He, Shang Zhi Zi, Huang Qin)
TONGUE
Pu Huang Pollen Typhae, Huai Hua Flos Sophorae japonicae, Zhu Ye Folium Bambusae.
CHEST CAVITY
Huang Yao Zi Rhizoma Dioscoreae bulbiferae, Xia Ku Cao Spica Prunellae vulgaris, Kun Bu Thallus Laminariae seu Eckloniae, Dan Nan Xing Rhizoma Arisaematis.
BLOOD (LEUKEMIA)
Qing Dai Indigo Pulverata Levis.
BLADDER
Xia Ku Cao Spica Prunellae vulgaris, Tian Kui Zi Radix Semiaquiligiae, Shi Shang Bai Herba Selaginallae, Lou Lu Radix Rhapontici seu Echinopsis, Teng Li Gen Radix Actinidiae argutae.
THYROID
Huang Yao Zi Rhizoma Dioscoreae bulbiferae, Zhe Bei Mu Bulbus Fritillariae Thunbergii, Xia Ku Cao Spica Prunellae vulgaris.
EXAMPLES OF HERBAL PRESCRIPTIONS
In order to give examples of herbal prescriptions for patients with cancer, we must distinguish three situations:
a) Patient with cancer before chemo-/radio-therapy
b) Patient during chemo- or radio-therapy
c) Patient after surgery and radio-/chemo-therapy
a) Patient with cancer before chemo-/radio-therapy
When treating a patient with cancer before they had Western treatment the first thing to do is to diagnose the Chinese disease (Bian Bing) and the second is identify the patterns (Bian Zheng). We need to diagnose the Chinese disease because it gives us an idea of prognosis, pathology and treatment. I have given a list of Chinese diseases with corresponding type of cancer in the previous blog post.
For example, carcinoma of the thyroid may be compared to Shi Ying, a type of goiter. If we read about Shi Ying, we can learn something about the pathology and treatment of this condition. Of course, this is important to do but it is not enough because the Chinese disease of Shi Ying would not entail the concept of malignancy.
Secondly, we need to identify the patterns involved: we cannot formulate a treatment for cancer if we do not identify the patterns. These are also closely linked to the Chinese disease. For example, in the case of Shi Ying, there is always Phlegm and Blood stasis (which makes the goiter feel hard on palpation).
The next essential step is to diagnose whether the patient's condition is primarily Full or Empty. This guides us to the choice of prescription, i.e. expelling pathogenic factors (in Full conditions) or tonifying the body's Qi (in Empty conditions). As I explained in the previous post, I generally primarily tonify the body's Qi in the beginning stages and primarily expel pathogenic factors in the middle-late stages.
The emphasis is on the word "primarily" because any prescription I use would simultaneously tonify the body's Qi and expel pathogenic factors albeit in different degrees. Thus, a prescription to expel pathogenic factors would have at least one or two tonics and a prescription to tonify the body's Qi would have some herbs to resolve Phlegm and invigorate Blood, choosing preferably from the herbs that also have an anti-cancer effect from the point of view of modern research.
Finally, when choosing herbs, we should keep into account the pattern they treat but also modern research. For example, if we need a Qi/Yang tonic, we would prefer Ren Shen or Huang Qi over Lu Rong because the former two herbs have an anti-cancer effect and Lu Rong does not.
Another example could be that of herbs for Toxic Heat. If we need a herb that resolves Toxic Heat, Shan Dou Gen Radix Sophorae tochinchinensis would be preferable to Qian Li Guang Herba Senecionis Scandens.
Therefore I would summarize the steps necessary for the choice of a herbal prescription are as follows:
1) Identify the Chinese disease
2) Identify the pattern
3) Decide whether the condition is primarily Full (in which case we primarily expel pathogenic factors) or primarily Empty (in which case we primarily tonify the body's Qi).
4) Choose a formula that suits the pattern
5) Add some tonics if we are expelling pathogenic factors or some herbs to resolve Phlegm, invigorate Blood and clear Toxic Heat if we are tonifying the body's Qi.
5) Modify it with the addition of herbs that have an anti-cancer effect.
The following is an example of a prescription for a patient with breast cancer. She is a 45-year old woman who was diagnosed with breast cancer 2 years previously. She had several hard lumps and the skin over the lumps was reddish-purple. Her tongue was swollen with a sticky coating with red points in the chest/breast area. Her pulse was Fine but Wiry on the left and Fine-Weak on the right.
The clinical signs and tongue give a very clear indication of Phlegm, Blood stasis and Toxic Heat:
Phlegm: swollen tongue with sticky coating, breast lumps.
Blood stasis: hard lumps.
Toxic Heat: reddish-purple skin on breast, red points breast area on tongue.
The pulse reflects the combination of pathogenic factors (being Wiry) and deficiency (being Fine and Weak on the right).
There is no doubt in my mind that the condition is primarily Full and that we therefore need to expel pathogenic factors. I chose the formula Ru He Nei Xiao Tang Breast Nodule Inner Dissolving Decoction 乳 核 內 消 湯 that moves Qi, invigorates Blood and resolves Toxic Heat. I modified it as follows:
Qing Pi Pericarpium Citri reticulatae viride (in original formula)
Xiang Fu Rhizoma Cyperi (in original formula)
Yu Jin Radix Curcumae (in original formula)
San Leng Rhizoma Sparganium
Dang Gui Radix Angelicae sinensis (in original formula)
Bai Shao Radix Paeoniae alba (Chi Shao in original formula)
Shan Ci Gu Pseudobulbus Cremastrae (in original formula)
Xia Ku Cao Spica Prunellae (in original formula)
Lou Lu Radix Rhapontici (in original formula)
Si Gua Luo Retinervus Luffae fructus (in original formula)
Gua Lou Pi Pericarpium Trichosanthis
Bai Hua She She Cao Herba Hedyotis diffusae
Ban Xia Rhizoma Pinelliae preparata
Huang Qi Radix Astragali membranacei
Gan Cao Radix Glycyrrhizae (in original formula)
Lu Lu Tong Fructus Liquidambaris taiwaniani
The formula is well suited to this patient as it moves Qi, invigorates and breaks Blood and resolves Toxic Heat.
I added San Leng to break Blood;
changed Chi Shao to Bai Shao to nourish Blood (pulse Weak and Fine on the right);
added Gua Lou Pi and Ban Xia to resolve Phlegm;
added Huang Qi to strengthen the immune system;
added Lu Lu Tong to direct the formula to the breast.
Lu Lu Tong is one of few herbs which are said to "penetrate the breast Luo channels" (tong ru luo). These herbs can be used as messenger herbs to reach the breast but they also remove obstructions from the breast. Additionally, Lu Lu Tong is indicated here because it also invigorates Blood.
b) Patients with cancer during chemo-/radio-therapy
The treatment of cancer patients who are undergoing chemo-therapy and/or radio-therapy is entirely different. During chemo- or radio-therapy we do not treat the patterns underlying the cancer but concentrate on supporting the immune system and minimizing the side-effects of treatment.
The treatment principle during chemotherapy is to tonify Qi, nourish Yin, cool Blood, resolve Dampness and clear Heat.
The treatment principle during radiotherapy is to nourish Blood, cool Blood, nourish Yin and invigorate Blood.
Unfortunately, there is a widespread view among oncologists that patients who are undergoing chemotherapy should not take antioxidants. The reason for this would be that chemotherapy oxidates cancer cells to destroy them and therefore anything that is anti-oxidant would stop chemotherapy from working. I disagree with this view and, in any case, Chinese herbs do not contain antioxidants.
c) Patients after surgery and radio-/chemo-therapy
When treating patients after surgery and radio- or chemotherapy, we need to assess them from a Chinese medicine perspective. We need to evaluate whether the patterns that caused cancer in the first place are still there.
I base this assessment primarily on the tongue and pulse. The three main patterns in cancer are Blood stasis, Phlegm and Toxic Heat and if the tongue and pulse show signs of these, I consider the cancer still active even if it has been eradicated by surgery and treated by radiotherapy and/or chemotherapy.
Therefore if the tongue is purple (Blood stasis) and swollen (Phlegm) and the pulse Full, I treat the patient as if the cancer were still there.
The tongue on the top is purple (Blood stasis) and swollen (Phlegm). When evaluating whether there is Blood stasis, we should also look at the sublingual veins. The tongue on the bottom shows dark and swollen veins which indicates Blood stasis.
A purple colour is not the only dangerous sign. If the tongue is red with many red points, it indicates Toxic Heat. Toxic Heat always indicates a poor prognosis because it means the cancer may spread: all the more so if the pulse is rapid.
 |
| Red points |
As for the pulse, a pulse of the Full type (wiry, slippery, firm) indicates that the pathogenic factors that caused cancer are still active. A pulse of the Empty type (weak, fine) indicates that the condition is primarily Empty.
Therefore, if tongue and pulse show that the pathogenic factors are still active, I give a prescription that primarily eliminates pathogenic factors. I say "primarily" because I would always add some tonic herbs that support the immune system. In addition to that, I would also use some herbs with an anti-cancer effects indicated above.
If the tongue and pulse show that the pathogenic factors are not active and that there is a pronounced deficiency, I then prescribe a formula that primarily tonifies (Qi, Yang, Blood or Yin). Again, I say "primarily" because the formula would also include 1-2 herbs to expel pathogenic factors and 1-2 herbs with anti-cancer effect.
The following is an example of a prescription for a patient after treatment with surgery and chemotherapy and with which I primarily expelled pathogenic factors.
A 63-year-old female patient had ovarian cancer 3 years previously. She had a hysterectomy and oophorectomy followed by chemotherapy. A few months before the consultation they discovered some "lumps" in the abdomen for which she had more chemotherapy.
Her tongue was reddish-purple and her pulse was wiry and full in general and weak on both Kidney positions.
I diagnosed severe Blood stasis on the basis of the tongue and pulse with an underlying Kidney deficiency. Based on the tongue and pulse and the recurrence of lumps, I decided that the treatment should be aimed primarily at expelling pathogenic factors, in her case at invigorating Blood.
I used the following prescription:
Dang Gui Radix Angelicae sinensis (Invigorate Blood)
Chi Shao Radix Paeoniae rubra (Invigorate Blood)
Yi Mu Cao Herba Leonuri heterophylli (Invigorate Blood)
Chuan Niu Xi Radix Cyathulae officinalis (Invigorate Blood)
E Zhu Rhizoma Curcumae Ezhu (Break Blood)
San Leng Rhizoma Sparganii stoloniferi (Break Blood)
Bai Hua She She Cao Herba Hedyotis diffusae (Anti-cancer)
Ban Zhi Lian Herba Scutellariae barbatae (Anti-cancer)
Huang Qi Radix Astragali membranacei (Tonify Qi, support immune system)
Tu Si Zi Semen Cuscutae chinensis (Tonify Kidney-Yang)
The following is an example of a prescription for a patient after treatment with surgery and chemotherapy and with which I primarily tonified Zheng Qi.
This case history is unfortunately an example of a radical Western treatment with surgery and chemo- or radiotherapy and yet the pathogenic factors were obviously still active as the ovarian cancer was followed by bowel cancer and breast cancer.
Her tongue was pale, slightly swollen with a sticky coating. Her pulse was weak on both Kidney positions.
As the tongue is pale and the Kidney positions weak, she obviously suffered from a Kidney-Yang and Spleen-Yang deficiency. However, the slight swelling of the tongue shows Phlegm..
Based on the tongue and pulse, I decided that my primary aim should be to tonify Spleen- and Kidney-Yang and only secondarily to resolve Phlegm. I used the following prescription:
Huang Qi Radix Astragali membranacei (tonify Qi, support immune system)
Bai Zhu Rhizoma Atractylodis (tonify Qi, support immune system, tonify Spleen-Yang)
Fu Ling Poria (resolve Phlegm)
Chen Pi Pericarpium Citri reticulati (resolve Phlegm)
Tu Si Zi Semen Cuscutae chinensis (tonify Kidney-Yang)
Xu Duan Raadix Dipsaci asperi (tonify Kidney-Yang)
Ban Xia Rhizoma Pinelliae preparatum (resolve Phlegm)
Bai Hua She She Cao Herba Hedyotis diffusae (Anti-cancer)
I also prescribed the mushroom Coriolus.
PROGNOSIS
When I see a patient who has had cancer and been treated with surgery and radio-/chemotherapy. I formulate a prognosis on the basis Chinese diagnosis based most of all on tongue and pulse.
Poor prognosis
Tongue purple or red with red points, swollen; pulse Full (wiry, slippery, firm, overflowing). The prognosis is particularly unfavourable if the pulse is also rapid.
Good prognosis
Tongue normal or pale, not swollen; pulse weak in general.
In case of breast cancer, one should pay particular attention to the breast area on the tongue which was discussed in a previous post:
https://www.blogger.com/blogger.g?blogID=5267943865157480550#editor/target=post;postID=500023099400554790;onPublishedMenu=posts;onClosedMenu=posts;postNum=3;src=postname
OTHER THERAPIES
Of course, for the treatment of cancer we must use other therapies and in particular:
Diet
Qi Gong
Antioxidants
Mushrooms
Of the medicinal mushrooms, I particularly use Coriolus.
