Chinese herbs for cancer: Facts, folklore, and fabrications surround their use

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These dried Chinese herbs harbor many unknowns, such as age, quality, and presence of herbicides, pesticides, and fungicides. Photo courtesy Dr. Narda Robinson

Any time a loved one, including an animal companion, faces a diagnosis of cancer, many of us might wonder whether an effective alternative to chemotherapy, radiation, or surgery exists, given the side effects of conventional options.1,2

An internet search could bring up this—an article written by a veterinarian, making these claims: “TCVM (traditional Chinese veterinary medicine) may be a standalone or adjunctive treatment for animal cancer patients. It not only treats cancer, but can potentially prevent recurrence and metastasis.”3

Does that not sound like a dream come true? Not so much. An integrative medicine practitioner, looking for answers in published literature, could find a statement such as this: “Clinical evidence indicates that traditional Chinese medicine (TCM) and TCVM can benefit treatment of cancer in both humans
and animals.”4

The authors provide no convincing evidence, describing cancer as stemming from “chi deficiency” and “blood stasis,” which begins to raise questions. They advocate a line of proprietary Chinese mixtures sold by one of the author’s companies, and few to none of the ingredients have been studied rigorously in target species showing safety and effectiveness.

Not only that, but proprietary formulae appear to violate The Principles of Veterinary Medical Ethics of the American Veterinary Medical Association (AVMA): “Veterinarians shall not promote, sell, prescribe, dispense, or use secret remedies or any other product for which they do not know the ingredients.”5 Yet, many of our colleagues do just that.

Even links between TCM and the illegal wildlife trade do not seem to dissuade some veterinarians from selling Chinese herbs.6 This devastating connection, driven largely by TCM, has made the survival of thousands of species, including rhinos and elephants, unsustainable.7,8,9 So, how are we to believe statements such as this, published in the American Journal of Traditional Chinese Veterinary Medicine? “Endangered species are not part of Chinese herbal formulas for humans or animals today.”10

What modern science says

Since 2018, the medical literature has burgeoned with papers on Chinese “herbs” for cancer, covering everything from standard approaches, such as astragalus and ginseng, to more obscure extracts of blister beetle and toad venom.11

Most of the papers include discussion of the pharmacologic mechanisms by which Chinese herbs exert their effects. They talk about how the herbs may alter the tumor immunosuppressive microenvironment12 or demonstrate anti-cancer, immunomodulatory activities.13

Some Asian herbs act as chemosensitizers and radiosensitizers;14 others are chemoprotective15 and radioprotective.16 How all these herbs and drugs interact when co-administered remains anybody’s guess.

Pharmacologic descriptions notwithstanding, many papers written in China promote TCM in a curiously positive light. Especially in a journal such as Cancer Medicine, it seems out of place to find a passage like this: “CHM [Chinese Herbal Medicine] is considered a gift of nature and these compounds derived from herbs have the advantage of availability, efficacy, and relatively low toxicity compared with chemotherapy. Evidence has confirmed that TCM in combination with chemotherapy or radiotherapy is capable of promoting the efficacy of and diminishing the limitations and drawbacks induced by chemotherapy and radiotherapy.”17

What’s going on?

An article in World Finance provides some clues: “The Chinese government–specifically, President Xi Jinping–is consciously driving the expansion of the TCM market at present. This became all too clear in a speech he gave in spring 2018, during which he also outlined plans to stay on as premier indefinitely. According to sources familiar with the matter, he devoted at least half an hour of his speech strictly to TCM and explained there was no need to test the efficacy and toxicity of such treatments … Clearly, there is a strong financial incentive for promoting TCM around the globe … Moreover, Xi’s TCM ambitions have a strong political component. Dr. Donald Marcus, professor of Medicine and Immunology Emeritus at the Baylor College of Medicine, told World Finance: ‘He’s pushing it very hard for two reasons. One, he’s on a campaign to promote China as a great power and a source of all kinds of wonderful cultural and scientific things. He’s also facing the same problem that Chairman Mao faced, which is that they don’t have enough western-trained doctors to take care of a huge Chinese population, so they’re promoting the idea that TCM is just as good.’ ”18

Financial Times adds: “China is vying with the U.S. to be the global leader in terms of research volume.”19 Volume is one thing; quality is quite another. The article continues, “[E]xperts say that China’s impressive output masks systemic inefficiencies and an underbelly of low-quality and fraudulent research” … ”The world’s scientific publishers are becoming increasingly alarmed by the scale of fraud. An investigation last year by their joint Committee on Publication Ethics (COPE) concluded: ‘The submission of suspected fake research papers…is growing and threatens to overwhelm the editorial processes of a significant number of journals.’”

The matter of fraudulent research extends beyond just Chinese herbs. Several years back, according to ScienceAlert, the Chinese State Food and Drug Administration (SFDA) assessed the data from 1,622 clinical trials regarding new pharmaceutical drugs–not TCM mixtures. The governmental agency found more than 80 percent of the data provided from these trials had been “fabricated.”20 The article continues: “Not only did the report find that many of the ‘new’ drugs awaiting approval were actually a combination of existing drugs, they also showed that many clinical trial outcomes were written before the trials had actually taken place, and the data had been simply manipulated to match what companies wanted to find.”

Impacting vet med

This leaves those of us, who prefer to practice with a science-based, rational approach, unsure of what and whom to trust. How might we sidestep the quagmire of folklore, scientific fraud, and suppression of science and find out which herbs actually help our patients with cancer?

Independent investigations will be key, especially because “China [intends] to roll back regulations for traditional medicine despite safety concerns” and “Scientists fear plans to abandon clinical trials of centuries-old remedies will put people at risk.”21

Researchers outside of China (i.e. those who can speak freely) agree. “Traditional Chinese Medicine needs proper scrutiny” and, “New laws that promote centuries-old herbal remedies are a backwards step for China. Only controlled clinical trials can satisfy concerns.”22

On the other hand, scientists within China operate in a different climate, as the Chinese government does not tolerate such critique and punishes healthcare workers who dare to question promotional claims. A few years ago, the government imprisoned an anesthesiologist for describing a mixture as “poison.”23 The “medicinal liquor” he warned consumers about “contains more than 60 kinds of herbs and animal products. It is advertised as a cure for everything from rheumatism to kidney dysfunction, joint pain, and Alzheimer’s disease.” After being jailed, he no longer publicly questioned TCM.

Where to from here?

A better way forward exists, as exemplified by certain companies within the cannabis industry, where we see authenticated certificates of analyses, placebo-controlled clinical trials, and sustainable, organic agriculture. It is obviously doable, but would require TCVM to drop the mysticism, the secret formulae, and potentially toxic ingredients.

Narda Robinson, DO, DVM, MS, FAAMA, practices osteopathic medicine and veterinary medicine. Dr. Robinson taught science-based integrative medicine at the Colorado State University College of Veterinary Medicine and Biomedical Sciences for 20 years. In 2016, Robinson established her own academy in Fort Collins, Colo., where she teaches medical acupuncture, integrative rehabilitation, medical massage, and other integrative medical approaches.

References

  1. Lana SE, Kogan LR, Crump KA, Graham JT, and Robinson NG. The use of complementary and alternative therapies in dogs and cats with cancer. J Am Anim Hosp Assoc. 2006;42(5):361-365.
  2. Kramer ML, Larsen JA, and Kent MS. Changes in diet and supplement use in dogs with cancer. J Vet Intern Med. 2023;37(5):1830-1838.
  3. Yamate M. TCVM: An integrative approach to treating cancer. Innovative Veterinary Care. August 14, 2019. Accessed on October 1, 2023 at https://ivcjournal.com/tcvm-an-integrative-approach-to-treating-cancer/ .
  4. Xie H and Hershey B. Chinese herbal medicine for the treatment of cancer. American Journal of Traditional Chinese Veterinary Medicine (AJTCVM). 2015;10(1):69-75.
  5. American Veterinary Medical Association Website. Principles of veterinary medical ethics of the AVMA. Accessed on October 4, 2023 at https://www.avma.org/resources-tools/avma-policies/principles-veterinary-medical-ethics-avma .
  6. Kelly R. Pangolin finding raises ethical question for veterinarians. VIN News. April 18, 2022. Accessed on October 4, 2023 at https://news.vin.com/default.aspx?pid=210&catId=621&id=10893275.
  7. Cheung H, Mazerolle L, Possingham HP, et al. China’s legalization of domestic rhino horn trade: Traditional Chinese Medicine practitioner perspectives and the likelihood of prescription. Front Ecol Evol. 21 April 2021. Volume 9 – 2021. Accessed on October 4, 2023 at https://www.frontiersin.org/articles/10.3389/fevo.2021.607660/full.
  8. Aljazeera Website. Chinese traditional medicine growth in Africa threatens wildlife. November 10, 2021. Accessed on October 4, 2023 at https://www.aljazeera.com/news/2021/11/10/chinese-traditional-medicine-growth-in-africa-threatens-wildlife.
  9. Environmental Investigation Agency. World Health Organisation urged to condemn traditional Chinese medicine utilising wild animal parts. May 20, 2019. Accessed on October 4, 2023 at https://eia-international.org/press-releases/world-health-organisation-urged-to-condemn-traditional-chinese-medicine-utilising-wild-animal-parts/#:~:text=Many%20species%20included%20in%20TCM,United%20Nations%20global%20biodiversity%20report.
  10. Xie H. Chinese veterinary herbal medicine: History, scientific validation and regulations. AJTCVM. 2012; 7(1): 1-5. Accessed on October 4, 2023 at https://www.iopeyes.com/wp-content/uploads/2019/02/herbal-industion-regulations-and-validation-review.pdf.
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  15. Li S, So T-H, Tang G, et al. Chinese herbal medicine for reducing chemotherapy-associated side-effects in breast cancer patients: a systematic review and meta-analysis. Front Oncol. 2020;10:599073. 2020 Dec 9. doi: 10.3389/fonc.2020.599073.
  16. Zhang X, Chen X, Want L, et al. Review of the efficacy and mechanisms of Traditional Chinese Medicines as a therapeutic option for ionizing radiation induced damage. Front Pharmacol., 15 February 2021. Sec Ethnopharmacology. Volume 12 – 2021 | https://doi.org/10.3389/fphar.2021.617559.
  17. Xiang Y, Guo Z, Zhu P, et al. Traditional Chinese medicine as a cancer treatment: Modern perspectives of ancient but advanced science. Cancer Med. 2019;8(5):1958-1975.
  18. Matsangou E. The dark underbelly of the traditional Chinese medicine boom. World Finance. Accessed on October 3, 2023 at https://www.worldfinance.com/markets/the-dark-underbelly-of-the-traditional-chinese-medicine-boom?fbclid=IwAR1TaYD8jzPJSiEGNncacU124DH4EhICGScazENPa7ufJBcY6OKvvw-8dIc#:~:text=Pressure%20from%20above,stay%20on%20as%20premier%20indefinitely.
  19. Olcott E, Cookson C, and Smith A. China’s fake science industry: how ‘paper mills’ threaten progress. Financial Times. March 27, 2023. Accessed on October 3, 2023 at https://www.ft.com/content/32440f74-7804-4637-a662-6cdc8f3fba86?fbclid=IwAR1t8ExfgQuCBSekZmq47q8psc8-ZoQ5nkyt1ivN5jwGPbKtX4HsGOUM2VM.
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