Author(s): Wang-Dapeng#, Qi-Xiangbo#, Wu-Maomao, Zhu-Xinwei, Wu-Linlin, He-Junjun and Xie-Jianguo*
Professor Xie Jianguo, originating from a lineage of medical experts and a direct apprentice of Professor Zhang Xue Wen—China’s inaugural national medical master-has dedicated four decades to the clinical practice of Traditional Chinese Medicine (TCM). His scholarly insights and clinical acumen represent a treasured contribution to the TCM domain. The ‘living with cancer’ treatment philosophy has, to a significant degree, revolutionized conventional cancer treatment paradigms. This concept emphasizes extending survival time while ensuring the quality of life of patients, rather than simply pursuing the complete disappearance of tumors. Professor Xie advocates for a balance between tumors and the body, and in the practice of living with cancer, he combines internal and external TCM treatments, as well as strategies to support health and suppress cancer, providing support for the modernization and internationalization of TCM in oncology and bringing new hope for cancer patients worldwide.
Professor Xie Jianguo’s TCM philosophy on living with cancer is centered on the concept of “Harmonious Coexistence and Human- Centric Approach”. This philosophy is rooted in thousands of years of TCM theory and practice, as well as a profound understanding of the challenges posed by modern cancer treatments. Professor Xie posits that while cancer is a severe disease, the relationship between the human body and cancer is not entirely antagonistic. Instead, a state of relative balance can be achieved through the holistic perspective and syndrome differentiation and treatment of TCM, known as living with cancer.
In terms of the origin of this philosophy, Professor Xie draws on the philosophical ideas of “Unity of Heaven and Man” and “Yin-Yang Balance” from “Huangdi Neijing”, viewing the human body as a complex ecosystem in which cancer is a product of imbalance. He emphasizes that treating cancer should not focus solely on eliminating the lesion but should also adjust the internal environment of the body, restore yin-yang balance, and enhance the body’s self-repair and resistance to external pathogens. This concept aligns with the Western medical concept of “living with cancer,” but TCM’s approach to “living with cancer” places greater emphasis on individualized holistic regulation.
Regarding the core concept, Professor Xie proposes the treatment principle of “people-oriented and harmonious but different”. He believes that each patient’s constitution, disease condition, and psychological state are unique, requiring personalized and flexible treatment plans. Through precise syndrome differentiation and treatment, employing various therapeutic methods such as herbal medicine, acupuncture, and tuina (Chinese Therapeutic Massage), the goal is to improve patients’ quality of life and extend survival, rather than merely pursuing the reduction or disappearance of tumors. This philosophy has been validated in clinical practice, with many patients experiencing not only effective control of their conditions but also a significant improvement in quality of life after receiving Professor Xie’s treatment.
Within Professor Xie’s TCM oncology practice, the synergistic approach of herbal internal administration with external treatment has demonstrated distinctive benefits and efficacy. He highlights that herbal internal administration allows for the customization of individualized prescriptions, addressing specific patient conditions and achieving multifaceted therapeutic goals, including the harmonization of yin and yang, the replenishment of qi and blood, heat clearance and detoxification, and the enhancement of blood circulation to resolve stasis. At the same time, combined with external treatments such as herbal patches and fumigation, they can directly act on the lesion area, accelerate local blood circulation, promote drug absorption, and further improve the therapeutic effect.
Specifically, Professor Xie once treated a patient with liver cancer who turned to TCM after ineffective Western medical treatment. Based on the patient’s physical characteristics and disease progression, he formulated a treatment plan combining herbal internal administration with external treatment. The internal prescription mainly focused on soothing the liver, resolving depression, and promoting blood circulation to remove blood stasis, using herbs such as Bupleurum, Curcuma, and Salvia, aiming to regulate liver function and inhibit tumor growth. At the same time, herbal patches were applied to the liver area, using the transdermal absorption of drugs to directly act on the lesion, alleviate patient pain, and improve quality of life. After several months of treatment, the patient’s tumor markers significantly decreased, symptoms were significantly improved, and the goal of living with cancer was achieved.
In addition, Professor Xie also focuses on using modern technological methods to quantify the effects of herbal internal administration and external treatment. He cited a clinical study that showed that among cancer patients treated with a combination of herbal internal administration and external treatment, 80% of patients experienced symptom relief and improved quality of life after treatment; at the same time, 60% of patients had a reduction or stabilization of tumor volume after treatment. These data fully prove the effectiveness and feasibility of the combination of herbal internal administration and external treatment in the treatment of living with cancer.
As the ancient TCM classic “Huangdi Neijing” said, “The best doctor treats diseases before they occur, not after they have occurred.” Professor Xie adheres to this wisdom of TCM, focusing not only on the treatment of tumors but also on the overall adjustment and recovery of the patient’s body, achieving a harmonious symbiosis between the tumor and the body. This treatment philosophy not only brings hope and vitality to patients but also opens up new paths for the development of TCM in the field of oncology.
The Strategy of Supporting Health and Suppressing Cancer Supporting health and suppressing cancer constitutes a pivotal strategy in TCM for treating patients living with cancer, focusing on modulating the dynamic between the body’s vital energy and tumor cells, thereby prolonging survival and enhancing quality of life.
In clinical practice, Professor Xie particularly emphasizes the rational use of the strategy of supporting health and suppressing cancer. He advocates that during the treatment process, based on the specific situation of the patient, a comprehensive consideration of the pros and cons of supporting health and suppressing cancer should be taken, and an individualized treatment plan should be adopted. In terms of supporting health and replenishing deficiency, Professor Xie focuses on harmonizing yin and yang, replenishing qi and blood, and strengthening the function of the viscera. Commonly used drugs include but are not limited to ginseng, astragalus, and atractylodes, which can enhance the body’s vital energy, improve physical fitness, and enhance immunity. In terms of anti-cancer and tumor suppression, Professor Xie selects Chinese medicinal materials with anti-tumor activity according to the specific situation of the patient, such as Ganoderma lucidum, Scutellaria baicalensis, and Angelica dahurica, as well as modern Chinese medicinal preparations, through internal and external treatment, focusing on local treatment of tumors while also emphasizing overall regulation, aiming to achieve the best survival state for patients living with cancer.
Professor Xie, after years of clinical observation and research on advanced lung cancer, recognizes that the etiology is due to the internal environmental disorder caused by the disharmony of the viscera’s yin and yang, and the disharmony of qi and blood meridians, leading to the interaction of phlegm, stasis, and toxins. The pathogenesis is characterized by the decline of vital energy and the inability to resist the progression of cancer, which is essentially a deficiency with a superficially excessive presentation.
Patients with advanced lung cancer have lesions in the lungs, leading to the loss of the lung’s down function, subsequently damaging lung qi. With age and the prolonged illness depleting the body’s vital essence, the lung qi and yin become exhausted, blood circulation is weakened, heart qi is deficient, and the disease affects the spleen as the mother organ, leading to spleen deficiency. The prolonged illness also affects the kidneys, causing Kidney Failure to Accept Qi, resulting in both yin and yang deficiencies. As stated in “Huangdi Neijing”, “The kidney is the root of congenital essence, and the spleen is the root of acquired essence”, highlighting their interdependent relationship. “Jingyue Quanshu” mentions, “The lung is the master of qi, and the kidney is the root of qi”, and “Gujin Yitong” states, “The lung is the pivot of qi, and the spleen is the source of qi”. Therefore, in patients with advanced lung cancer, the vital energy of the lung, heart, spleen, and kidneys often interacts and declines, leading to long-term suffering from the disease, a decline in vital energy, a worsening of physical function, and an inability to resist the invasion of cancer toxins, creating a vicious cycle of pain and disease. Hence, Professor Xie believes that treatment should focus on invigorating vital energy, resisting cancer toxins, and living with the tumor, emphasizing the nourishment of the lungs, spleen, and kidneys. Medicinals such as American ginseng, astragalus, Cordyceps, atractylodes, Chinese yam, poria, polygonatum, adenophora, gypsophila, ophiopogon, and rehmannia are often used to boost qi and nourish yin, enhancing vital energy.
Furthermore, the pathological factors of advanced lung cancer are often related to phlegm, stasis, and toxins caused by the disharmony of the viscera’s yin and yang and the disharmony of qi and blood meridians. Phlegm, stasis, and toxins are not only factors of internal environmental disorder but also the main culprits that exacerbate the development of cancer and further damage the internal environment. When the yin and yang of the viscera are harmonious and the qi and blood meridians are unobstructed, phlegm, stasis, and toxins do not arise. “Yizong Bixue” states, “The spleen is the source of phlegm, and the lung is the vessel for storing phlegm”. Professor Xie believes that to treat phlegm, one should start with treating the spleen, which is the root, with the intention of nurturing the earth to generate metal. By protecting the spleen and stomach, phlegm will naturally be regulated. If phlegm is not regulated, it can obstruct the meridians for a long time, leading to stagnation of qi, obstruction of blood circulation, and the formation of stasis, which can eventually turn into heat and toxins. The treatment should focus on resolving phlegm, softening hardness to suppress tumors, removing stasis, and detoxifying the meridians, aiming to achieve the goal of living with the tumor. Commonly used Medicinals include Ephedra, Farfarae Flos, Asteris Radix, Houttuyniae Herba, Armeniacae Semen, Trichosanthes Fructus, Fritillariae Bulbus, and Pumex, to disperse lung qi, resolve phlegm, and relieve cough; Codonopsis, Dioscoreae Rhizoma, Atractylodis Macrocephalae Rhizoma, Astragalus, Amomi Fructus, Poria, Alismatis Rhizoma, Citri Pericarpium, Aucklandiae Radix, Hordei Fructus Germinatus, Setariae Fructus, Galli Endothelium, and Dioscoreae Nucleus, to strengthen the spleen, regulate qi, transform dampness, and promote the flow of water; Carthamoidis Flos, Curcumae Radix, Crataegi Fructus, Paeoniae Radix, Myrrha, Frankincense, Salviae Miltiorrhizae Radix et Rhizoma, and Ligustici Chuanxiong Rhizoma, to activate blood, remove stasis, and unblock the meridians; and Fritillariae Thunbergii Bulbus, Scrophulariae Radix, Ostrea Concha, Prunellae Spica, and Sodium Sesquicarbonate, to soften hardness, suppress tumors, and detoxify.
The formation and development of liver cancer is a protracted pathological process, primarily attributed to a deficiency in the body’s vital energy and dysregulation of visceral functions, which allows external pathogens to invade and reside within the body, leading to stagnation and blockage of qi and blood in the meridians. This condition, when accumulated over time, ultimately results in tumor formation. Chronic illness can lead to stagnation of qi and blood, which in turn can generate toxicity. The rapid growth of cancer toxins can easily spread through the meridians, obstructing the flow of qi, leading to qi stagnation. The stagnation of qi can further hinder blood circulation, forming blood stasis and mass-like swellings, and also cause disturbances in the distribution and metabolism of body fluids, leading to the accumulation of phlegm. Long-term stagnation turning into heat forms damp-heat, which, when lingering in the body, becomes difficult to cure. Cancer toxins can consume qi, blood, and vital energy, leading to the weakening of visceral functions and a decrease in the body’s immune system. Therefore, treatment focuses particularly on supporting vital energy and detoxification. In response to this pathological mechanism, Professor Xie often uses herbs such as Astragalus Membranaceus (Huang Qi), Panax Quinquefolius (Xi Yang Shen), Codonopsis Pilosula (Dang Shen), Atractylodis Macrocephalae Rhizoma (Bai Zhu), Dioscoreae Rhizoma (Shan Yao), and Polygonati Rhizoma (Huang Jing) to support vital energy and enhance the body’s immune system; at the same time, he uses herbs such as Cyathulae Radix (Dang Gui), Alismatis Rhizoma (Ze Xie), Plantaginis Semen (Che Qian Zi), Artemisiae Capillaris Herba (Yin Chen), and Salviae Miltiorrhizae Radix et Rhizoma (Dan Shen) to detoxify and eliminate toxins.
Furthermore, the liver and kidneys originate from the same source, and the growth of tumors can consume yin blood during the process. The liver is yin in nature but yang in function, being the organ that stores blood. Liver yin deficiency can affect kidney yin, leading to insufficient kidney yin, which in turn fails to nourish the liver wood, resulting in liver yin deficiency as well. The yin and blood deficiency of the liver and kidneys affect each other. When the liver and kidneys are deficient in yin and blood, the liver loses nourishment, leading to the liver’s failure to regulate and its dysfunction in dispersing and descending, resulting in the stagnation of liver qi. Professor Xie focuses on nourishing the kidneys and liver, moistening water to contain wood, so that when kidney yin is sufficient and liver wood is nourished, liver qi is relieved, blood stasis is resolved, and mass-like swellings are eliminated. Clinically, he often uses herbs such as Rehmanniae Radix (Sheng Di Huang), Rehmanniae Radix Preparata (Shu Di Huang), Lycium Fructus (Gou Qi Zi), Adenophorae Radix (Sha Shen), Paeoniae Alba Radix (Bai Shao), and Polygonati Rhizoma (Huang Jing) to nourish the liver and kidneys, enrich yin, and nourish blood.
“Seeing the disease of the liver, one knows that the liver should transmit it to the spleen, so first strengthen the spleen’s qi, and do not let it be affected by the liver’s evil...” Therefore, in the treatment process of liver cancer, special attention should be paid to protecting the spleen and stomach qi. When the spleen and stomach are healthy and functioning well, the production of qi and blood has a source, enhancing the body’s immune system and resisting diseases. Professor Xie often includes herbs such as Panax Quinquefolius (Xi Yang Shen), Astragalus Membranaceus (Huang Qi), Atractylodis Macrocephalae Rhizoma (Bai Zhu), and Dioscoreae Rhizoma (Shan Yao) in his prescriptions to strengthen the spleen and boost qi; Fructus Crataegi (Shan Zha), Massa Medicata Fermentata (Shen Qu), Hordei Fructus Germinatus (Mai Ya), and Galli Endothelium (Ji Nei Jin) to strengthen the spleen, aid digestion, and transform accumulation; and Paeoniae Radix (Bai Shao), Paeoniae Radix Rubra (Chi Shao), and Bupleuri Radix (Chai Hu) to nourish and soothe the liver.
Traditional Chinese Medicine (TCM) believes that the occurrence of renal cancer is often due to a deficiency of vital energy, coupled with the stagnation of the seven emotions, internal injury from improper diet, and the invasion of pathogenic toxins, which leads to an imbalance of yin and yang in the body, and the reversal of qi and blood, accumulating with qi, phlegm, dampness, stasis, and heat, forming a condition of deficiency at the root and excess at the branch, with kidney deficiency being the key to the pathogenesis, making kidney supplementation crucial. Professor Xie uses a primary formula consisting of Panax Quinquefolius (Xi Yang Shen), Polygonati Rhizoma (Huang Jing), Sinapis Albae Semen (Bai Jie Zi), and Fritillariae Thunbergii Bulbus (Zhe Bei Mu), supplemented with herbs that strengthen the spleen and boost energy, warm the kidney yang, and nourish blood, all working together to achieve the effects of benefiting the kidneys, filling essence, dispersing masses, and reducing tumor size.
In the TCM theoretical system, the formation of renal cancer is often related to the body’s weakened vital energy, which provides an opportunity for disease to occur. When an individual experiences emotional fluctuations, such as melancholy and anger, which lead to the stagnation of the seven emotions, or improper diet causing internal injury, coupled with the invasion of external pathogens, these factors collectively disrupt the body’s yin-yang balance and cause disorder in the circulation of qi and blood. In this process, pathogenic products such as qi stagnation, phlegm coagulation, dampness obstruction, blood stasis, and heat toxicity fight each other and eventually accumulate in the body to form tumors, a condition known in TCM as a deficiency at the root and excess at the branch. Among these, kidney deficiency is the core of the entire pathogenesis, hence the key to treating renal cancer lies in kidney supplementation.
Professor Xie, in treating renal cancer, employs a formula with Panax Quinquefolius (Xi Yang Shen), Polygonati Rhizoma (Huang Jing), Sinapis Albae Semen (Bai Jie Zi), and Fritillariae Thunbergii Bulbus (Zhe Bei Mu) as the main ingredients. Panax Quinquefolius can supplement qi and nourish yin, Polygonati Rhizoma has the effects of strengthening the spleen, boosting energy, and nourishing yin and kidney, Sinapis Albae Semen can resolve phlegm and disperse masses, and Fritillariae Thunbergii Bulbus has the functions of clearing heat, resolving phlegm, and dispersing swelling. The combination of these medicines aims to fundamentally regulate the body, enhance vital energy, and is supplemented by other herbs that strengthen the spleen, boost energy, warm the kidney yang, and nourish blood, all acting on the body to achieve the effects of benefiting the kidneys, filling essence, dispersing masses, and reducing tumor size.
Sun, female, 82 years old, initial consultation on January 6, 2005. The patient presented with symptoms of confusion, chest oppression, cough, shortness of breath, anorexia, and peripheral edema. She had been experiencing dyspnea and was unable to lie flat for half a year, with symptoms worsening over the past month and a half, oliguria of 700ml/day, and constipation. Her tongue showed signs of blood stasis with a dark and grayish coating, and her pulse was faint and thin. Laboratory tests revealed a serum albumin level of 55.27μg/L, globulin level of 26.94μg/L, blood urea nitrogen of 14.3mmol/L, creatinine of 124.7μmol/L, and proteinuria of 3+. Ultrasound showed pleural effusion on the right side with a depth of approximately 9.0cm and on the left side with a depth of approximately 2.6cm.
To invigorate Qi and nourish Yin, transform stasis, and promote diuresis.
Follow-up on January 13, 2005, the patient’s mental state improved, her complexion became more radiant, cough and chest distress symptoms improved, she was able to rest flat, appetite improved, and bowel movements were unobstructed. Re-examination by ultrasound showed a reduction in pleural effusion on both sides, auscultation revealed absent breath sounds in the lower lobes of both lungs, and no moist rales were heard. The original prescription was adjusted to increase Cordyceps to 1.5g, Plantain Seed to 30g, and added Amomum 5g.
On January 21, 2005, the third consultation, the patient had returned home for recuperation, was in high spirits, had a good appetite, and was able to take care of daily activities. Re-examination by ultrasound showed a significant reduction in pleural effusion on the right side to a depth of 2cm, complete disappearance of pleural effusion on the left side, and resolution of peripheral and lower limb edema, with further improvement in symptoms. The prescription was adjusted by removing Sponge Gourd Network, Aquilaria, Long Pepper, and Amomum, and adding Cinnamon 10g, Stir-fried Atractylodes 25g, Sichuan Lovage Fruit 15g, Roasted Barley Sprout 20g, and Stir-fried Dioscorea 20g, ginger skin as a guide, 7 doses, one dose per day in small amounts. Follow-up showed survival for more than three years, with the patient able to take care of herself, while three fellow patients in the same ward had passed away within three years.
The patient, being elderly and physically weakened, had a deficiency of vital energy and an excess of pathogenic factors, compounded by previous overtreatment. The initial treatment focused on bolstering vital energy and rescuing the primary Qi to enable the patient to expel pathogenic factors. American Ginseng, Cordyceps, and Astragalus Membranaceus (roasted) were used to greatly supplement vital energy, strengthen the kidneys, and consolidate the lungs. “The kidney is the root of Qi, and the lung is the master of Qi,” and considering both is essential to address the root cause. Sandalwood, Aucklandia, Perilla Stem, Aquilaria, and Nine Fragrance Insect, which are fragrant and promote the movement of Qi, were used to regulate Qi, aid digestion, and resolve accumulation. “The spleen and stomach are the source of Qi and blood production,” and a healthy functioning of the spleen and stomach can consolidate the acquired constitution and ensure the production of Qi and blood. Allium Macrostemon was used to broaden the chest and resolve phlegm, Alisma and Plantain Seed to drain the pathogenic factors from the kidneys, Sponge Gourd Network to dredge the meridians, and Long Pepper to treat the stagnation of water due to deficiency and cold in the lower burner, with a small amount of Angelica Sinensis to activate blood, resolve stasis, detoxify, and not harm the healthy Qi. The entire prescription contains both supplementary and purgative herbs, addressing both the support of healthy Qi and the expulsion of pathogenic factors.
Wu, male, 66 years old, initial consultation on July 29, 2006. The patient had right hypochondriac pain without apparent cause four months prior. Ultrasound examination revealed a space-occupying lesion in the right lobe of the liver, and MRI confirmed a diagnosis of primary liver cancer (early stage). He underwent partial resection of the right lobe at Zhongshan Hospital in Shanghai. During the postoperative hospital stay, he had persistent low-grade fever, poor appetite, poor sleep, dyspnea, shortness of breath, weak speech, and extreme fatigue. One month later, the symptoms worsened, and he felt extremely uncomfortable. Examination at Dalian Sixth Hospital revealed a large amount of fluid in the thoracic and abdominal cavities. Treatment with hepatoprotective drugs and traditional Chinese patent medicines (Xi Huang Wan, etc.) was ineffective, and he was notified of critical condition multiple times. Current symptoms include mental confusion, delirium, yellowing of the eyes, a sallow complexion, a distended abdomen like a drum, chest and abdominal pain, dyspnea, low- grade fever (around 37.3°C), fatigue, poor appetite, vomiting of phlegm, slight edema of the lower limbs, loose stools that are purplish and sticky, 2-3 times a day, and yellow and turbid urine. The tongue is dark purple with a gray and greasy coating, and the pulse is moist, thin, and rapid.
To nourish the liver and kidneys, soften hardness and disperse masses, promote diuresis, and unblock the meridians.
7 doses, one dose per day, taken warm in small amounts.
After the initial prescription of 7 doses, there was a noticeable improvement in the patient’s mental state, with an increase in appetite, reduction in hypochondriac bloating and pain, vomiting of phlegm, and dyspnea. The low-grade fever and slight edema of the lower limbs disappeared, indicating an improvement in the condition. The treatment protocol was not changed, and Guanzhong and Baijiesi were removed, while Danshen 30g and Dafenpi 30g were added. The patient was prescribed 14 doses to be taken twice daily, warm and divided.
At the third consultation, the patient’s mental state further improved, with the yellowing of the eyes, sallow complexion, hypochondriac bloating and pain, vomiting of phlegm, and dyspnea all resolved. The stool was soft and yellow, once daily, and the urine was light yellow. The tongue was dark red with a thin white and slightly greasy coating, and the pulse was moist, thin, and rapid. The condition further improved, and the patient was able to take care of daily activities. The prescription was adjusted by removing Dafenpi and adding Danggui 15g, with 14 doses to be taken twice daily, warm and divided.
Subsequent adjustments were made according to the symptoms, and after more than 60 doses, the abdominal distension like a drum basically disappeared. The patient felt refreshed, had a good appetite, occasional slight pain in the liver area, and normal bowel movements. The tongue was dark red with a thin white coating, and the pulse was string-like, thin, and slightly rapid. Adhering to the principle of “living with the tumor” and based on the specific changes in the condition, the patient took traditional Chinese medicine intermittently over a long period and has survived for more than 5 years.
“When the body’s vital energy is strong, external pathogens cannot invade,” and “where there is a gathering of evil, there must be a deficiency of energy.” A deficiency of vital energy is the internal cause of malignant tumors. External pathogens take advantage of this deficiency, become entrenched, and cause disorder in the functions of the viscera, leading to blockages in the meridians and blood, resulting in pathologies such as qi stagnation and blood stasis. Over time, this leads to the formation of tumors. Additionally, the growth of tumors consumes the body’s qi and blood, and surgery can injure qi and the spleen, leading to further deficiency of vital energy. Therefore, it is essential throughout the treatment to adjust and nourish vital energy, enhance the patient’s resistance to disease. In the prescription, American ginseng and Astragalus were used together to replenish qi and nourish yin, diuretic, and address the pathogenesis, serving as the sovereign drugs. Turtle shell and soft-shelled turtle shell assist American ginseng in replenishing qi, nourishing yin, and clearing heat, while Paeoniae Radix Alba enters the liver meridian, nourishes blood, and restrains yin, softening the liver and relieving pain, enhancing the analgesic effect when used with licorice. Atractylodes has a sweet and bitter taste, is warm in nature, and is the “number one medicine for replenishing qi and strengthening the spleen,” which can also diuretic and prevent the spread of liver disease to the spleen. Roasted barley sprout, roasted divine ?, and stir-fried chicken gold are used together to strengthen the spleen and aid digestion, serving both as symptomatic treatment and to assist in the digestion of shell-like substances. Citrus aurantium, Buddha’s hand, and sponge gourd network all enter the liver meridian to soothe the liver and regulate qi, ensuring the smooth flow of qi, and sponge gourd network can also enter the liver to activate blood and unblock the collaterals to relieve pain. Plantain seed and Alisma help with diuresis and reduce swelling. The entire prescription is well-matched, taking into account qi, blood, and water stasis, treating the liver and spleen together, with precise medication, addressing the pathogenesis.
Zhang, male, 77 years old, initial consultation on August 5, 2008. The patient was hospitalized in the urology department on September 26, 2007, with a chief complaint of “suddenly visible hematuria and difficulty urinating for 2 days without obvious cause.” A CT of the urinary system confirmed bilateral renal pelvis space-occupying lesions, suspected renal pelvis cancer, and the left kidney could not rule out the formation of blood clots in the renal pelvis. Diagnosed with: right renal pelvis cancer, left renal pelvis occupation. On October 6, 2007, he underwent a total nephrectomy and ureterectomy of the right kidney under general anesthesia, and a ureteral bladder wall flap resection. Postoperative pathology showed: renal pelvis squamous cell carcinoma with lymphocyte infiltration. The patient was in general good condition and was discharged after improvement. One month after the operation, without obvious cause, symptoms of frequent urination, urgency, and dysuria appeared. A review of the urinary system CT: the right kidney was absent after surgery, and there was an occupying lesion in the left renal pelvis measuring 2.6cm×1.8cm, left renal pelvis cancer. The patient was advised to undergo surgery, but the patient and family disagreed with the surgery and requested conservative observation. Recently, the patient’s symptoms have been recurring and the condition has worsened, so they came to the clinic today. Current symptoms include: fatigue, back pain, fear of cold, weak waist and knees, difficult and incomplete urination, lower limb edema, palpable indentation, poor appetite, and unformed stool.
TCM Diagnosis: Bloody strangury, deficiency of qi and blood, spleen and kidney yang deficiency
Western Medicine Diagnosis: Renal cancer
Treatment Principle: Benefit the kidneys, disperse masses, detoxify, and reduce tumor size
Prescription: Xie’s Renal Cancer Formula No. 1 with additions and subtractions
Lower limb edema, palpable indentation, other symptoms improved compared to before, blood pressure 140/85 mmHg, poor appetite, unformed stool. Adjusted prescription: removed Stir-fried Atractylodes and Cinnamon, added Sinapis Albae Semen 10g, Deer Antler 4g, Achyranthes Bidentata 30g, increased Rehmanniae Radix to 30g, 14 doses to be taken warm in the morning and evening.
Previous symptoms significantly alleviated, blood pressure around 140/80 mmHg, urea nitrogen 17.23 mmol/L, creatinine 467 μmol/L, poor appetite, soft and loose stool. Adjusted prescription: removed Papaya and Large-bellied Skin, added Polygonum Multiflorum 25g, decreased Rehmanniae Radix to 20g, 21 doses to be taken warm in the morning and evening.
Symptoms further alleviated, blood pressure 120/80 mmHg, urea nitrogen 14.21 mmol/L, creatinine 329 μmol/L, poor appetite, yellow and soft stool. Adjusted prescription: removed Alisma and Achyranthes Bidentata, added Stir-fried Chicken Gold 20g, 30 doses to be taken warm in the morning and evening.
All symptoms disappeared, blood pressure stable, urea nitrogen 11.87 mmol/L, creatinine 176 μmol/L, good appetite, yellow and soft stool. Adjusted prescription: added Achyranthes Bidentata 30g, 30 doses to be taken warm in the morning and evening.
The patient felt refreshed, had a rosy complexion, gained 3kg in weight, no recurrence of fatigue, back pain, or edema, blood pressure 122/78 mmHg, urea nitrogen 11.34 mmol/L, creatinine 169 μmol/L. Follow-up and Treatment Continuation.
Re-examination of the urinary system CT revealed the absence of the right kidney (post-surgery) and an occupying lesion of 1.7cm×0.9cm in the left renal pelvis, indicating left renal pelvis cancer. The patient reported a sweet taste in food and soft, yellow stools. The previous prescription was continued for 30 doses, to be taken warm in the morning and evening.
The patient has been taking traditional Chinese medicine for thousands of doses over six years in an outpatient setting, with self-care, refreshed spirit, increased physical strength, and a sweet taste in food. On March 4, 2012, a re-examination of the urinary system CT showed no occupying lesions in the left kidney, with an irregular shape and no clear abnormal density within the renal parenchyma. The patient continued to take traditional Chinese medicine for another two years to consolidate the treatment.
The etiology and pathogenesis of renal cancer are complex, often caused by cold-dampness, qi stagnation, and blood stasis. In this case, the mechanism is characterized by the accumulation of cold and stasis, with spleen and kidney deficiency. Therefore, the treatment principle was to strengthen the spleen and kidneys, resolve phlegm, and reduce the tumor. Cinnamon and dodder were used to tonify kidney yang, while polygonatum and rehmannia were used to nourish kidney yin, achieving a balance of yin and yang. Astragalus, American ginseng, and stir-fried atractylodes were combined to boost qi and strengthen the spleen, ensuring the source of qi and blood production. Since renal cancer has formed into a mass due to phlegm and stasis, and the pathogenic factors must be expelled for the healthy qi to be stabilized, Zhejiang bei, scrophularia, and fresh oyster shell were used to resolve phlegm and reduce the tumor. The combined use of these medicines aimed to support healthy qi and dispel pathogenic factors, achieving the goal of cancer treatment.
In summary, Professor Xie adheres to the therapeutic principle of “people-oriented and harmonious yet diverse,” tailoring treatments to the individual patient’s constitution, disease condition, and psychological state. By employing a variety of therapeutic methods including traditional Chinese medicine, acupuncture, and tuina (Chinese therapeutic massage), he effectively improves the quality of life for cancer patients, extends their survival, and controls the disease progression. His approach significantly enhances the patients’ quality of life. His academic ideas and clinical experiences constitute a valuable asset in the field of traditional Chinese medicine, which deserves to be inherited and promoted
