Because liver cancer progresses rapidly and affects multiple organs, especially the spleen and stomach are hit first, damaging vital energy and leading to a state where righteousness cannot resist pathogenic factors. Despite full efforts in diagnosis and treatment based on differentiation, the outcome is often prolonged survival with disease rather than cure. Undoubtedly, it remains necessary to explore the patterns of TCM treatment for liver cancer.
Principles of Liver Cancer Treatment
One, the principle of reinforcing righteousness and eliminating pathogenic factors: For early-stage liver cancer in patients with normal constitution, treatment must prioritize "eliminating pathogenic factors with supporting righteousness as auxiliary." Only by seizing this favorable opportunity can some patients achieve clinical cure; otherwise, only life extension is possible without cure. For mid-to-late stage liver cancer with weakness and metastasis, treatment must prioritize "reinforcing righteousness with eliminating pathogenic factors as auxiliary." If one persistently attacks pathogenic factors without using or underusing tonic herbs, it may lead to depletion of vital energy. Even if tumor size decreases, most patients still cannot extend life, resulting in inefficiency.
Two, the principle of treating disease and differentiating syndromes: Once early-stage liver cancer is diagnosed, the essence of the disease must be grasped. Although there may be no obvious symptoms initially, treatment should still emphasize eliminating pathogenic factors with anticancer herbs, while simultaneously combining herbs that strengthen the spleen and stomach, soothe the liver, regulate qi, and activate blood circulation to resolve nodules. In mid-to-late stage liver cancer, complex syndromes involving deficiency, excess, cold, and heat emerge constantly. Based on disease recognition, treatment must follow changes in condition, carefully select herbs, and adopt flexible approaches to promptly resolve critical and dangerous conditions. Otherwise, rigid adherence to disease classification while ignoring changing syndromes leads to missing opportunities, often causing premature death in liver cancer patients—a great regret. Physicians must always remember the importance of syndrome differentiation and treatment.
Three, the principle of treating liver and spleen: The sage Zhang Zhongjing stated, "When seeing liver disease, know that it affects the spleen; thus, treat the spleen first," highlighting the holistic concept of interrelated internal organs. The liver governs free flow, the spleen governs transformation and transportation. The liver and spleen regulate the distribution of qi and blood in the body. Dysregulation of liver and spleen essentially represents the fundamental pathological mechanism of liver cancer. Therefore, treating liver cancer must begin with regulating liver and spleen; isolated treatment of the liver without addressing the spleen is inadequate. Moreover, clinically, mid-to-late stage liver cancer often presents with symptoms such as abdominal distension, poor appetite, and reduced food intake—indicative of "spleen deficiency." Thus, regulating liver and spleen not only embodies the holistic approach of TCM in treating liver cancer but also effectively addresses metabolic and immune dysfunctions caused by spleen deficiency. Regulating liver and spleen is therefore a fundamental principle in treating liver cancer.
Four, the principle of activating blood circulation and stopping bleeding: Blood stasis is one of the key pathogenic mechanisms in liver cancer. Patients with liver cancer exhibit hypercoagulability in blood rheology, providing scientific basis for treatment with blood-activating and stasis-resolving methods. Clinically, using blood-activating and stasis-resolving herbs for liver cancer has proven effective—suppressing cancer cell growth, reducing cancer thrombi formation, preventing metastasis, and promoting softening and absorption of fibrous tissue. However, in mid-to-late stage liver cancer, complications such as upper gastrointestinal bleeding may occur, even rupture of liver cancer nodules leading to hematemesis and melena. Therefore, avoiding strong blood-breaking herbs is essential to prevent exacerbating bleeding risk in liver cancer patients, which could even promote cancer cell dissemination. Hence, when selecting blood-activating and stasis-resolving herbs, safer options like Sanqi Powder, Madder Root, Fairy Grass, Raw Punica, Angelica, and Rhubarb—herbs with dual action of activating blood circulation and stopping bleeding—are preferred.
Five, the principle of internal and external treatment: In mid-to-late stage liver cancer, the condition is perilous. Only through combined internal and external treatments can patient suffering be quickly alleviated and lifespan extended. Indeed, internal disease treated externally is one of the distinctive features of TCM. Though liver cancer is an internal organ disease, its manifestations appear externally—such as liver region pain, even severe pain, and ascites. Therefore, applying aromatic substances like Musk, Toad, Frankincense, Myrrh, and Borneol, soaked in alcohol for one week, externally applied to acupoints around the Qimen point (liver region), combined with internal herbal medicine, achieves rapid pain relief and tumor reduction. Applying Musk, Raw Astragalus, Erchou, and Gansui on the navel, combined with internal herbs, enables diuresis without harming righteous Qi.
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