Clinical Applications and Effectiveness of TCM

Now, let's delve into the practical applications of Traditional Chinese Medicine in the context of modern
healthcare, specifically focusing on its effectiveness in managing and supporting patients with Colorectal
Cancer, Liver Cancer, and Breast Cancer.

Traditional Chinese Medicine, while perhaps not as aggressive in directly combating diseases as some
Western treatments, truly shines in its ability to mitigate the adverse effects of those treatments. Integrating
TCM with Western medicine can lead to a powerful synergy, reducing side effects like fatigue and skin
rashes, improving the patient's overall quality of life, and in some cases, even prolonging survival. So, in
modern days, TCM often used with western medicine.

Integrated Traditional Chinese and Western Medicine Treatment

Think about it this way: Western medicine is incredibly effective at targeting and attacking diseases, but it
often comes at a cost. It can cause varying degrees of harm to normal, healthy tissues in the body. This can
manifest as bone marrow suppression, gastrointestinal dysfunction, hair loss, damage to vital organs like the
heart, liver, kidneys, and lungs, neurological injuries, and even, in some cases, carcinogenic effects. TCM
steps in to address these very issues.

Colorectal Cancer (CRC)

Let's start with Colorectal Cancer. It's important to understand some key factors. Colorectal cancer ranks as
the third most common cancer globally, with a concerning rise in incidence among younger populations. In
the United States, early-onset CRC, diagnosed in individuals under 50, accounts for a significant 25% of all
cases. Several risk factors are associated with CRC, including pre-existing bowel diseases like IBD, obesity,
and lifestyle factors such as sedentary habits, a diet high in red meat, and smoking.

Now, how can TCM help in this situation? We can tell by looking at some clinical trials.

Clinical Trial: TCM + Chemotherapy (FOLFOX + TCM

Prescriptions)

One area where TCM is proving to be quite valuable is in conjunction with chemotherapy regimens like
FOLFOX. For those unfamiliar, FOLFOX is a chemotherapy regimen commonly used to treat colorectal
cancer. It's a combination of folinic acid, fluorouracil (5-FU), and oxaliplatin. Folinic acid enhances the
effects of fluorouracil, while fluorouracil inhibits DNA synthesis in cancer cells, and oxaliplatin alkylates
DNA, disrupting replication and transcription.
While FOLFOX is effective in improving survival rates, it can also cause significant side effects, such as
peripheral neuropathy, nausea, and fatigue. This is where TCM comes in.

TCM and FOLFOX: Reducing Side Effects

A meta-analysis of randomized controlled trials investigated the combination of spleen-strengthening and

JianPiHuaTan Formula (JPHTF)

Another promising avenue is the JianPiHuaTan Formula, or JPHTF. A 2024 trial evaluated patients with
stage II/III and stage IV CRC, comparing JPHTF as an adjuvant therapy alongside chemotherapy versus
chemotherapy alone. JPHTF, a herbal formula containing Astragalus membranaceus and Atractylodes
macrocephala, was administered daily for six months. In TCM theory, It strengthens the spleen to enhance
digestion and energy, harmonizes the stomach and intestines to improve digestive health, and balances yin
and yang forces to restore internal equilibrium. Additionally, JPHTF boosts immune function, helping the
body to fight cancer cells more effectively.

In stage II/III patients, JPHTF improved abdominal distension, fatigue, and appetite loss. And in stage IV
patients with RAS/RAF mutations, the formula showed a 4.3-month increase in median overall survival.
Transcriptomic analysis revealed that JPHTF downregulated Hippo and Hedgehog signaling pathways,
reducing tumor proliferation and enhancing immune infiltration.

How JianPiHuaTan Formula (JPHTF) Works?

JPHTF suppresses tumor growth by downregulating Hippo and Hedgehog pathways, blocking pro-
proliferative genes and inducing apoptosis. It also enhances antitumor immunity by reducing
immunosuppressive factors and recruiting CD8+ T cells, converting immunologically "cold" tumors to "hot"
ones. This dual mechanism synergizes direct tumor suppression with immune activation, offering potential
for combination therapies like checkpoint inhibitors.

In simple terms, JPHTF stops tumor growth by turning off cancer’s "growth switches" and boosts immune
attack by removing cancer’s "smoke screens," allowing more "soldier" T cells to find and kill tumors. This
makes JPHTF a promising partner for existing treatments like immunotherapy.
Liver Cancer

Let's turn our attention to Liver Cancer. In Hong Kong, liver cancer is the fifth most common cancer and the
third leading cause of cancer deaths. In 2022, there were 1,612 new cases, accounting for 4.6% of all new
cancer cases. Men are at a significantly higher risk than women.

Clinical Trial: Huachansu Injection Combined with TACE

One interesting approach involves combining Transarterial Chemoembolisation (TACE), the standard of
care for unresectable hepatocellular carcinoma, with Huachansu, a Chinese medicine derived from toad
venom. The combination of this two treatment method is suitable for those who are in late stage of disease
that considered unsuitable to undergo surgery.

A 2023 RCT study showed that the median overall survival was 14.8 months in the combination group
versus 10.7 months in the TACE-only group. The median progression-free survival was also longer in the
Huachansu–TACE group.

Clinical Trial: Cinobufacini Injection Combined with TACE

Another related treatment involves Cinobufacini Injection combined with TACE. Animal experiments have
shown that cinobufacini downregulates VEGF expression, inhibiting tumor angiogenesis through the AKT
signaling pathway. In vitro experiments confirmed that cinobufacini dose-dependently activates caspase-3,
promoting apoptosis, and suppresses BCL-2 expression, further supporting its pro-apoptotic effects.

Clinical Trial: Cinobufacini Injection Combined with TACE

(Summary)

In summary, TACE delivers chemotherapy directly to the tumor and blocks its blood supply. Huachansu
inhibits angiogenesis, induces apoptosis, and prevents metastasis. The combination enhances treatment
efficacy for liver cancer by targeting multiple pathways for tumor growth and survival.

Breast Cancer

Finally, let's consider Breast Cancer, in this part, I’ll mainly focus on the side effects of cancer treatment .
Approximately 97.4% of patients report at least one side effect during cancer treatment, with fatigue being
the most common. Common side effects include fatigue, loss of appetite, diarrhea, nausea, vomiting, hair
loss, neuropathy, and hormonal side effects like hot flashes and vaginal dryness. Long-term side effects,
such as persistent peripheral neuropathy, are also significant, particularly after chemotherapy.
Acupuncture for Hot Flashes in Cancer Patients

A study analyzed acupuncture records from cancer outpatients and found a median treatment response of a
25% reduction in hot flashes score. The study identified Qi stagnation and blood stagnation as common
TCM diagnoses, and found that older age, anxiety level, and damp accumulation were predictors of
response. In Traditional Chinese Medicine (TCM) theory, hot flashes are often associated with Qi
stagnation and blood stagnation. These conditions are believed to disrupt the body's internal
balance, leading to symptoms like hot flashes. Acupuncture aims to restore this balance by
unblocking meridians and regulating Qi and blood flow

This highlights the potential of acupuncture as a valuable tool in managing a common and distressing side
effect of breast cancer treatment.

Possible Side Effects

It's important to acknowledge that, like any treatment, TCM is not without potential side effects. While
generally considered safe when administered by qualified practitioners, some herbal remedies can interact
with conventional medications or cause adverse reactions in certain individuals. Toxicity is a consideration,
so it's crucial to source herbs from reputable suppliers and to follow the instructions from health care
practitioners.

Pros and Cons of TCM

Let’s take a balanced look at the advantages and disadvantages of Traditional Chinese Medicine, especially
in the context of cancer care.

Pros of TCM

• Holistic Approach: TCM considers the individual as a whole, addressing the root cause of the
disease rather than just the symptoms.
• Reduced Side Effects: TCM can help mitigate the side effects of conventional cancer treatments
like chemotherapy and radiation.
• Improved Quality of Life: TCM can improve a patient’s quality of life by alleviating symptoms
like pain, fatigue, and nausea.
• Personalized Treatment: TCM treatments are tailored to the individual patient’s unique condition
and constitution.
• Support for Overall Well-being: TCM can help strengthen the body’s immune system and promote
overall well-being.
Cons of TCM

• Lack of Standardized Dosage: The dosage of herbal remedies can vary, making it difficult to
determine the optimal dose for each patient.
• Potential Interactions: Herbal remedies can interact with conventional medications, potentially
reducing their effectiveness or causing adverse effects.
• Quality Control Issues: The quality of herbal products can vary, and some products may be
contaminated with toxins or heavy metals.
• Limited Scientific Evidence: While there is growing evidence supporting the effectiveness of TCM
for certain conditions, more research is needed to confirm its benefits.
• Time Commitment: TCM treatments often require a significant time commitment, including regular
visits to a practitioner and adherence to a specific lifestyle.

Conclusion

In conclusion, Traditional Chinese Medicine offers a valuable and complementary approach to cancer care.
While it may not be a standalone cure, its ability to alleviate side effects, improve quality of life, and
potentially enhance the effectiveness of conventional treatments makes it a powerful tool in the fight against
cancer.

It's important to remember that TCM should be integrated into a comprehensive treatment plan, working in
collaboration with your oncologist and other healthcare providers. By combining the best of both worlds –
the targeted power of Western medicine and the holistic, supportive approach of TCM – we can offer
patients the best possible chance for a positive outcome and a better quality of life.