TCM and Cancer: Supportive Care Evidence and Safety Concerns

Read this first

Chinese herbal medicine is not a treatment for cancer and has not replaced surgery, chemotherapy, radiation or other proven treatment. NCCIH advises: "Don't use TCM to replace or delay seeking conventional care." [1] Before starting any herb, tea or supplement during cancer treatment, tell your oncology team and pharmacist and show them the actual product. Herbs contain biologically active compounds and can potentially interact with prescription medicines, including chemotherapy drugs. [2] See talking with a health professional for a practical way to raise this.

What the research is (and is not)

Almost all trials of Chinese herbal medicine in cancer ask a narrow question: when a named herbal product is added to chemotherapy, radiation or other usual treatment, do survival, tumor response, quality of life or side effects differ from usual treatment alone? That is "supportive" or "adjunctive" care, not an alternative cancer treatment. Practitioners may describe the person by TCM patterns such as qi deficiency; those are traditional frameworks, and trials report measured outcomes. Practice details are in TCM oncology supportive care in practice.

What Cochrane reviews found

1. Esophageal cancer: herbs added to chemotherapy or radiation

   Unclear

   9 trials, 490 people, all in China, unclear or high risk of bias. Quality of life and some radiation or chemotherapy side effects looked better, with low or very low quality evidence; the authors found no evidence to determine whether TCM is an effective treatment for the cancer itself. [3]

   Insufficient evidence for cancer control; promising but limited for quality of life

2. Advanced colorectal cancer: herbs added to chemotherapy

   Unclear

   20 trials, 1,304 people. Some formulas were linked with better 1-year or 3-year survival and quality of life; herbs showed no extra benefit in response rate; no serious adverse effects were reported by trials. [4]

   Promising but limited; this 2012 review's abstract does not rate trial quality, and it allowed unblinded trials

Other trials and reviews

• Liver cancer (Huaier granule). A multicenter trial in China randomized 1,044 people after liver cancer surgery to Huaier granule (an extract of the fungus Trametes robinophila) or no further treatment. Recurrence-free survival was longer with Huaier (hazard ratio 0.67). [5] Because the comparison was no treatment rather than placebo, expectation could play a part; this is promising but limited until confirmed elsewhere.
• Lung cancer. A meta-analysis of 64 trials (4,384 people) of Chinese herbal medicine with EGFR-targeted drugs found better progression-free survival and other measures, but the authors said results require further confirmation. [6]
• Herbal injections. An overview of 52 reviews of Aidi injection, a Chinese herbal injection used in cancer care in China, found that 50 were rated critically low in quality and two low, mainly for lack of prospective registration. [7] (The reviewers counted outcomes favorable to the injection, but the quality of the reviews limits trust in that count.)

Interactions and safety

• Why it matters. The review describes two routes: effects on how the body handles a drug (pharmacokinetics) and effects on how the drug acts (pharmacodynamics). [2]
• Balanced picture. A systematic review of cancer patients using supplements found most of the interactions identified were theoretical and not supported by clinical data, and no study reported adverse events from the combinations. The authors called for better study rather than reassurance. [8]
• Contamination and adulteration. NCCIH reports Chinese herbal products with undeclared drugs, heavy metals, pesticides or wrong herbs, some of which caused organ damage. [1] See Chinese herbs during cancer treatment and liver injury from Chinese herbs.
• Before surgery. Herbs can matter around operations; see Chinese herbs before and after surgery.

Where evidence is missing

Proper evidence not found for Chinese herbs curing cancer, shrinking tumors without conventional treatment, or being safe with any particular chemotherapy drug. I searched PubMed for Cochrane reviews and systematic reviews of Chinese herbal medicine in cancer. Drugs developed from traditional sources are discussed separately in arsenic trioxide and other drugs with traditional origins. For nausea, see TCM for nausea and chemotherapy side effects.

Practical steps

Ask your oncology team whether any complementary approach is suitable for your treatment plan, bring product labels, and avoid products that promise to cure cancer. If you are exploring practitioners, see how to choose a TCM practitioner.