Qiu Peiran, the first National Master of Traditional Chinese Medicine, is a chief physician and professor at Shanghai University of Traditional Chinese Medicine.
Qiu Peiran has treated various types of tumors, including the following situations: patients diagnosed with tumors at an advanced stage who have lost the indication for surgery; patients with confirmed tumors who are unwilling to undergo surgery; patients who have had tumors surgically removed but have suffered significant damage to their qi and blood; patients who have interrupted treatment due to intolerable reactions from chemotherapy or radiotherapy; and patients who take traditional Chinese medicine while undergoing chemotherapy or radiotherapy to synergize their treatment.
The treatment goals of patients vary. For patients with advanced malignant tumors, the aim is to alleviate suffering and prolong life as much as possible; for patients who have had tumors surgically removed, the focus is on preventing recurrence or metastasis; for patients who have undergone multiple rounds of chemotherapy or radiotherapy, the goal is to relieve the toxic side effects of treatment. Below, we present Master Qiu’s treatment experiences for the benefit of colleagues.
Treatment Approach
Qiu Peiran’s fundamental approach to tumor treatment is that although tumors arise in specific local tissues or organs, the reactions caused by pathogenic factors are systemic, manifesting as depletion of the organs’ qi and blood, tissue damage, and functional disorders. According to the holistic view of traditional Chinese medicine (TCM), local lesions are the result of systemic dysfunction of the organs’ qi and blood. The areas of deficiency in the body are where pathogens reside. Therefore, it is insufficient to focus solely on the local tumor and seek “special” medicines to eliminate it. Decades of practical experience have shown that while certain heat-clearing and detoxifying medicines can have some efficacy in eliminating tumors, employing methods that adjust the body’s organ systems’ qi, blood, yin, and yang—known as “supporting the righteous qi”—is crucial for improving the body’s condition, alleviating symptoms, and eliminating the toxic side effects of chemotherapy and radiotherapy. This efficacy should not be underestimated, highlighting the differences between TCM and Western medicine in tumor treatment. While certain Western anti-tumor drugs can inhibit or kill tumor cells, the “toxicity” of these drugs also damages normal cells in the body. Therefore, Western medicine is beginning to consider enhancing the host’s defensive functions and eliminating potential subclinical lesions as important aspects of tumor treatment. Qiu Peiran believes that TCM should leverage its unique characteristics and advantages. He proposes that while it may be difficult to completely eliminate tangible accumulations like malignant tumors, the patient’s vital energy urgently needs support. He advocates for a treatment approach that, based on supporting the righteous qi, incorporates methods to clear heat and detoxify, invigorate blood and soften hard masses, and resolve phlegm and dissipate nodules to eliminate pathogens in tumor treatment.
Major Treatment Methods
He emphasizes adjusting qi, blood, yin, and yang, and tonifying the spleen and kidneys in the supportive treatment method. Qi-tonifying herbs include Ren Shen (Ginseng), Dang Shen (Codonopsis), Huang Qi (Astragalus), Bai Zhu (Atractylodes), Fu Ling (Poria), Shan Yao (Chinese Yam), and Gan Cao (Licorice); blood-tonifying herbs include Dang Gui (Angelica), Gou Qi Zi (Goji Berries), Shu Di Huang (Rehmannia), He Shou Wu (Fo-Ti), and Da Zao (Jujube); yin-nourishing herbs include Xi Yang Shen (American Ginseng), Sha Shen (Glehnia), Tian Dong (Asparagus), Mai Dong (Ophiopogon), Sheng Di Huang (Raw Rehmannia), and Shi Hu (Dendrobium); kidney-tonifying herbs include Gui Jiao (Tortoise Shell), Huang Bai (Phellodendron), Shan Yao (Cornus), Ba Jiao (Morinda), Tu Si Zi (Cuscuta), Xian Ling Pi (Epimedium), Bu Gu Zhi (Psoralea), Fu Zi (Aconite), Lu Jiao (Deer Antler), and Rou Gui (Cinnamon). In formulating prescriptions, Qiu Peiran often considers the balance of spleen and kidney qi, blood, yin, and yang, emphasizing the principle of mutual generation between yin and yang and the interdependence of essence and qi. In the supportive treatment method, it is also necessary to pay attention to adjusting the relationships between the organs. For example, if the liver and stomach are not in harmony, one should soothe the liver and harmonize the stomach; if the spleen and stomach’s ascending and descending functions are abnormal, one should use medicines that regulate these functions; if the spleen and kidneys are not effectively transporting fluids, one should adjust the spleen and kidneys to facilitate qi transformation. As for clearing heat and detoxifying, commonly used herbs include Xia Ku Cao (Selfheal), Huang Qin (Scutellaria), Huang Lian (Coptis), Pu Gong Ying (Dandelion), Mao Zhua Cao (Cat’s Claw), Shi Jian Chuan (Herba Hedyotis), Shan Ci Gu (Bletilla), Bai Hua She She Cao (Oldenlandia), and Shu Yang Quan (Shepherd’s Purse); blood-activating and stasis-resolving herbs include Tao Ren (Peach Kernel), Hong Hua (Safflower), Shao Yao (Peony), E Zhu (Curcuma), San Leng (Sparganium), Di Yu (Sanguisorba), and Zhi Gan Cao (Honey-fried Licorice); phlegm-softening and mass-dissolving herbs include Nan Xing (Arisaema), Ban Xia (Pinellia), Gua Lou (Trichosanthes), Mu Li (Oyster Shell), Kun Bu (Kelp), and Hai Zao (Sargassum). The role of insect-based medicines should not be overlooked, commonly used ones include Wu Gong (Centipede), Quan Xie (Scorpion), Di Long (Earthworm), Jiang Can (Silkworm), and Di Bie Chong (Beetle). In specific applications, the following situations require differentiated treatment. For patients with advanced disease, supporting the stomach qi to preserve life is crucial. In cases of advanced tumors, where tumor toxicity is widespread, pathogenic qi is strong, and righteous qi is weak, leading to damage to the organs and poor overall condition, treatment becomes particularly challenging. If one rashly attacks the pathogens, it will lead to adverse outcomes. Qiu Peiran’s experience indicates that all qi is deficient, so one should first support the stomach qi. The spleen and stomach are the source of life transformation; if the source is exhausted, the disease cannot be treated. If the stomach qi is still present, there is hope to preserve life. The medicine used is powdered Ren Shen, along with Huang Qi, Dang Shen, Tai Zi Shen (Pseudostellaria), Bai Zhu, Fu Ling, Huang Jing (Polygonatum), Gan Cao, Da Zao, and Sheng Jiang (Ginger), supplemented with Zhi Ke (Bitter Orange) and Chen Pi (Dried Tangerine Peel) to invigorate the stomach. If porridge enters the stomach and bowel movements are smooth, there is hope for survival. For managing the toxic side effects of chemotherapy and radiotherapy, the reactions post-treatment are due to the “toxicity” of the drugs damaging the organs’ qi and blood. Local reactions from radiotherapy generally include dry mouth, throat congestion, and throat pain, which should be treated with qi tonification and yin nourishment, using Huang Qi, Dang Shen, Tian Dong, Mai Dong, Yuan Shen (Radix Scrophulariae), Zhi Mu (Anemarrhena), Huang Bai, Huang Qin, Yin Hua (Lonicera), Lian Qiao (Forsythia), and Pu Gong Ying. Lower abdominal reactions include abdominal pain, diarrhea, and frequent urination, which should be treated with warming and harmonizing methods, using Ban Xia, Huang Lian, Gan Jiang (Dried Ginger), Gan Cao, Dang Shen, Bai Zhu, Zhi Ke, Mu Huo Xiang (Agastache), and Yi Yi Ren (Job’s Tears). Systemic reactions include dizziness, fatigue, loss of appetite, mental exhaustion, and leukopenia, which should be treated with spleen tonification and kidney support, using Dang Shen, Huang Qi, Bai Zhu, Dang Gui, Nu Zhen Zi (Ligustrum), Gou Qi Zi, Xian Ling Pi, Xian Mao (Curculigo), Shan Zhu Yu (Cornus), Dan Shen (Salvia), Bu Gu Zhi, Shu Di Huang, Gui Jiao, and Lu Jiao. The toxic side effects after chemotherapy mainly manifest as symptoms of qi and blood deficiency and spleen and kidney depletion. The treatment should focus on tonifying qi and nourishing blood, as well as supporting the kidneys and spleen. The herbs used include Ren Shen, Bai Zhu, Huang Jing, Fu Ling, Lu Jiao, Huang Qi, Dang Gui, Dan Shen, Zhi Gan Cao, Ba Jiao (Morinda), Bu Gu Zhi, Shan Zhu Yu, and Xian Ling Pi. For cancer pain management, the causes of cancer pain mainly include qi stagnation, blood stasis, cold congealing, phlegm accumulation, and excessive toxicity. Therefore, to alleviate pain, one can use methods to regulate qi, invigorate blood, disperse cold, resolve phlegm, and detoxify. The herbs used include Chuan Lian Zi (Melia), Yan Hu Suo (Corydalis), Chi Shao (Red Peony), Bai Shao (White Peony), Zhi Xiang Fu (Cyperus), Ru Xiang (Frankincense), Mo Yao (Myrrh), Cao Wu (Aconite), Fu Zi (Aconite), Xi Xin (Asarum), Di Bie Chong, Wu Gong, Quan Xie, and Shan Ci Gu. The dosage of the medicines should be slightly larger, and insect-based medicines can be ground into fine powder for better efficacy.
Pattern Differentiation and Treatment
● Spleen and Kidney Yang Deficiency
Warm yang and strengthen the spleen, main herbs: Huang Qi 30g, Dang Shen 24g, Chao Bai Zhu 15g, Bu Gu Zhi 15g, Rou Dou Kou 9g, Wu Wei Zi 12g, Gan Jiang 12g, Fu Zi 9g, Gan Cao 12g, etc.
● Liver and Kidney Yin Deficiency
Nourish yin and tonify liver and kidneys, main herbs: Zhi Mu 12g, Huang Bai 15g, Shu Di Huang 18g, Shan Zhu Yu 15g, Bie Jia 24g, Mu Li 30g, Nu Zhen Zi 15g, Shan Yao 18g, Dan Pi 12g, Fu Ling 20g, Dang Gui 15g, Gan Cao 12g, etc.
● Qi and Blood Deficiency
Tonify qi and nourish blood, main herbs: Sheng Bai Ren 12g, Tai Zi Shen 12g, Bai Zhu 15g, Fu Ling 18g, Gan Cao 12g, Dang Gui 15g, Chuan Xiong 12g, Shu Di 24g, Bai Shao 15g, etc.
● Phlegm and Stasis Toxicity
Resolve phlegm, invigorate blood, and soften hard masses, main herbs: Ban Xia 15g, Chen Pi 12g, Tu Fu Ling 30g, Pao Shan Jia 12g, Ge Gen 30g, Huang Qin 18g, Huang Lian 6g, Tao Ren 12g, Dan Pi 12g, Wu Yao 9g, Xuan Hu Suo 12g, Gan Cao 9g, Zhi Ke 12g, etc. Based on pattern differentiation, one can also add herbs with clear anti-cancer effects, such as Bai Hua She She Cao (Oldenlandia), Ban Zhi Lian (Scutellaria), Gui Jian Yu (Dysosma), Teng Li Gen (Smilax), Hong Teng (Sargentodoxa), She Liu Gu (Portulaca), Ma Chi Xian (Portulaca), Long Kui (Solanum), and Tu Fu Ling. For symptomatic adjustments: add Dang Shen, Gan Jiang, Huang Qin, Huang Lian, Yi Yi Ren, and Gan Cao for diarrhea; add Da Huang (Rhubarb) (to be taken later), Zhi Shi (Bitter Orange), Hou Po (Magnolia Bark), and Ma Zi Ren (Sesame Seed) for constipation; add Xiang Yuan Pi (Citron Peel), Chen Pi, Ji Nei Jin (Chicken Gizzard), Chao Mai Ya (Barley Sprout), and Shen Qu (Fermented Grain) for abdominal distension.
Case Study
Xie, a 69-year-old female, was first diagnosed on November 5, 1990. She reported rectal cancer three months post-surgery. Fifteen years prior, she discovered a lump in her left breast, which was diagnosed as breast cancer, and she underwent a radical mastectomy that year. This year, due to abdominal discomfort and occult blood in her stool, she was diagnosed with rectal cancer and underwent surgery in August at another hospital, where a colostomy was performed. The surgical wound healed well, and she underwent chemotherapy. Currently, she has one bowel movement per day, feels fatigued, experiences occasional dizziness, has a pale complexion, blurred vision, a thin tongue coating, and a fine, soft pulse. Pattern differentiation analysis: The etiology and pathogenesis of cancer are primarily due to the imbalance of the organs’ qi and blood, leading to stagnation of qi, phlegm, and toxins, resulting in conditions like breast cancer and intestinal cancer. The patient had breast cancer 15 years ago, and now rectal cancer has emerged, indicating that the root cause of the previous condition was not fully resolved, leading to a recurrence of the old pathogen after 15 years. After multiple surgeries, her qi and blood have been depleted, resulting in fatigue and a pale complexion. The treatment used is to nourish the righteous qi gradually. Diagnosis: (Righteous qi deficiency type) intestinal fungus; post-rectal cancer surgery. Treatment principle: primarily support the righteous qi, combined with regulating qi and detoxifying, softening hard masses, and dissipating nodules. Prescription: Sheng Bai Ren 9g, Huang Qi 30g, Sheng Bai Zhu 12g, Shu Di 30g, Ba Jiao 12g, Rou Cong Rong 15g, Dang Gui 12g, Mu Li 30g, Hai Zao 15g, Bai Hua She She Cao 30g, Xia Ku Cao 15g, E Zhu 12g, Mu Huo Xiang (each) 9g, Chen Pi 9g, 14 doses. On February 18, 1991, during the follow-up, the above prescription was adjusted and taken until now, and she reported a reduction in dizziness, palpitations upon movement, lower back soreness, and some difficulty in movement. Her appetite and bowel movements have improved, with a thin tongue coating and a fine, soft pulse. The treatment continued. Prescription: Dang Shen 15g, Huang Qi 30g, Sheng Bai Zhu 15g, Fu Ling 15g, Duan Mu Li 30g, Duan Long Gu (each) 30g, Shu Di 30g, Ba Jiao 12g, Gou Ji 15g, Gou Qi Zi 12g, Huai Niu Xi 15g, Xian Ling Pi 15g, 14 doses. On September 21, during the third follow-up, she reported difficulty walking with her lower limbs, fatigue, trembling fingers, and palpitations. She could sleep but had a thin tongue coating with teeth marks and a fine, deep pulse. The treatment continued to focus on supporting the righteous qi, combined with invigorating blood and dispelling wind. Prescription: Huang Qi 45g, Dang Gui 20g, Bai Shao 15g, Chuan Xiong 9g, Shu Di 30g, Hong Hua 9g, Zhi Di Long 9g, Tao Ren 15g, Gou Ji 15g, Qian Nian Jian 15g, Lu Jiao Fen 4.5g, Da Wu Gong 1 piece. 14 doses. On November 20, during the fourth follow-up, there was no change in symptoms, and the treatment was adjusted to Di Huang Yin Zi method. Prescription: Shu Di 30g, Shan Yu Rou 9g, Mai Dong 15g, Chuan Shi Hu 15g, Wu Wei Zi 9g, Rou Cong Rong 15g, Fu Ling 10g, Ba Jiao 15g, Shu Fu Zhi 9g, Shi Chang Pu 9g, Yuan Zhi 6g, Da Zao 7 pieces, Sheng Jiang 3g, Gui Zhi 15g, Bo He 4.5g. 14 doses. On December 14, during the fifth follow-up, her spirit was still good, but she had difficulty walking with her lower limbs, trembling fingers, and feelings of unease. She had a thin, greasy tongue coating and a deep, fine pulse. The previous prescription was continued. Prescription: Dang Shen 15g, Huang Qi 30g, Shu Di 30g, Shan Yu Rou 9g, Chuan Shi Hu 15g, Dang Gui 15g, Mai Dong 12g, Gou Qi Zi 15g, Fu Ling 12g, Rou Cong Rong 15g, Ba Jiao 15g, Duan Long Gu (each) 30g, Shi Chang Pu 6g. 14 doses. On January 4, 1992, during the sixth follow-up, she reported fatigue in her limbs, difficulty walking, and inconvenience in lifting her left upper limb. Palpitations had improved compared to before, and she could sleep well. The tongue coating and pulse remained the same. Prescription: Huang Qi 30g, Dang Gui 20g, Tao Ren 15g, Zhi Wu Gong 10g, Mu Huo Xiang (each) 10g, Zhi Ke 20g, Zhi Bie Jia 18g, Mu Li 30g, Shu Di 30g, Huang Bai 15g, Dan Shen 24g, E Zhu 15g. 14 doses. On February 22, during the seventh follow-up, she reported difficulty moving her neck and left waist. A CT scan from another hospital indicated cerebral arteriosclerosis. Prescription: Dan Shen 24g, Zhi Bie Jia 18g, Sheng Shu Di (each) 20g, Mu Li 30g, Huang Qi 40g, Fang Feng (each) 15g, Ba Jiao 15g, Rou Cong Rong 15g, Chuan Xiong 10g, E Zhu 15g, Xian Ling Pi 15g, Hong Hua 6g, Dang Gui 15g. 14 doses. On August 9, during the eighth follow-up, she reported fatigue, sluggish response, mild edema in the lower limbs, and poor sleep, with a thin tongue coating and fine pulse. The treatment focused on supporting the righteous qi, combined with promoting diuresis. Prescription: Huang Qi 40g, Da Wu Gong 2 pieces, Sheng Shu Di (each) 24g, Ba Jiao 15g, Rou Cong Rong 15g, Shi Chang Pu 10g, Zhi Yuan Zhi 6g, Chuan Shi Hu 18g, Mu Li 30g, Sheng Bai Zhu 18g, Ze Xie 15g, Huang Qin 12g. 14 doses. On September 20, during the ninth follow-up, the edema had subsided, but she appeared listless, with trembling limbs and difficulty moving her lower limbs. The tongue coating was thin, the quality was pale, and the pulse was fine and deep, indicating a deficiency of righteous qi and insufficient physical strength, making recovery difficult. Prescription: Shu Di 40g, Shan Yu Rou 9g, Chuan Shi Hu 18g, Mai Dong 15g, Wu Wei Zi 12g, Shi Chang Pu 10g, Yuan Zhi 6g, Fu Ling 12g, Rou Cong Rong 18g, Gui Zhi 15g, Duan Long Gu 15g, Bo He 6g, Sheng Jiang 4.5g. 7 doses. Note: The patient is elderly, and her vital essence is nearly depleted. Qiu Peiran’s proposed treatment method of nourishing the righteous qi is profound. The herbs used, such as Ren Shen, Huang Qi, Dang Gui, Shu Di, Bai Zhu, Gou Qi, and Mai Dong, greatly tonify qi and blood. For spleen deficiency, add Shan Yao and Fu Ling; for kidney deficiency, add Rou Cong Rong and Ba Jiao. Additionally, incorporating herbs that resolve swelling, soften hard masses, invigorate blood, and detoxify, such as Yi Yi Ren, Mu Li, Bai Hua She She Cao, E Zhu, San Leng, Ban Zhi Lian, and Mao Zhua Cao, can often improve symptoms, prolong survival time, and in some cases, lead to recovery.