🌿 Folk Prescriptions

Lung cancer presents complex symptoms, varying according to tumor location, size, type, stage, presence of metastasis, or complications. Early stages may be asymptomatic or present with mild symptoms. Central-type lung cancers show symptoms earlier than peripheral types. Typically, cough, hemoptysis, chest pain, fever, and dyspnea are seen across various syndromes of lung cancer. Their characteristic features are described as follows:
1. Cough: The most common early symptom. Patients often experience paroxysmal irritating cough or high-pitched obstructive cough, with little or no sputum, or only small amounts of white sticky sputum. If sputum clearance is difficult or phlegm turns into heat, cough intensifies, with yellow, thick, sticky sputum, red tongue, yellow coating, rapid pulse. Over time, both lung yin and lung qi become damaged. Lung yin injury manifests as dry cough, hemoptysis, low-grade fever, night sweats, red tongue; lung qi injury shows weak cough, shortness of breath, spontaneous sweating, fatigue, pale red tongue. In advanced stages, cough becomes weak and faint, sitting upright with panting, hoarse voice, cyanosis of lips, facial and limb edema—indicating depletion of qi, blood, yin, and yang.
2. Hemoptysis: Early presentation in tumors near the airway may first manifest as hemoptysis, intermittent, variable in amount, bright red or dark with foam, or blood mixed with sputum. Large vessel rupture or tumor necrosis forming cavities may cause uncontrollable bleeding, airway obstruction leading to suffocation, or death from blood loss. In deficiency-type hemoptysis, bleeding often fails to stop, with blood mixed in sputum, persistent over time. However, most cases begin with excess and progress to deficiency, showing mixed deficiency-excess patterns.
3. Chest Pain: Patients often experience varying degrees of chest pain. Early-stage lung cancer shows minimal pain, chest fullness, vague discomfort, primarily due to qi stagnation. In late stages, toxic pathogens invade deeply, blood stasis prevents circulation, pain worsens at night, becomes fixed and stabbing like a needle, even constant and unbearable, sometimes breaking through bone and flesh, painful to touch, preventing turning over.
4. Dyspnea: Early stage, vital energy not severely depleted, breathing high and loud, chest tightness and shortness of breath—commonly seen in excess patterns. Late stage, toxic pathogens dominate, both lung qi and yin severely damaged, resulting in shortness of breath with weak voice, chest tightness but not urgent, insufficient breath making movement worse, preferring rest, unable to work, shallow breathing—indicating excess pathogen and deficient vital energy.
5. Fever: A common symptom in lung cancer, usually due to internal yin deficiency heat, manifesting as afternoon or nighttime fever, or heat in hands and feet, accompanied by irritability, night sweats, dry mouth, sore throat. Fever may also result from phlegm-dampness blockage or internal toxin accumulation, with intense, persistent fever.
Advanced lung cancer leads to wasting and debility. Distant metastases at different sites may cause corresponding symptoms.
【Etiology and Pathogenesis】
To date, the exact cause of lung cancer remains unclear. However, based on patient history and clinical manifestations, the disease is closely related to deficiency of vital qi and invasion by pathogenic toxins.
1. Internal Deficiency of Vital Qi: “When vital qi resides internally, pathogens cannot invade,” and “where pathogens gather, vital qi must be deficient.” Internal deficiency of vital qi, leading to imbalance of zang-fu organs and yin-yang, is the main foundation for developing lung cancer—“accumulations form due to deficiency of vital qi, allowing pathogenic factors to settle.” Aging, weakened constitution, chronic pulmonary diseases, lung qi depletion; emotional injuries causing qi reversal and stagnation, disrupted ascending-descending functions; overwork damaging lung qi and lung yin, allowing external pathogens to invade, lingering and blocking qi flow, eventually causing blood stasis in the lungs, forming masses.
2. Internal Accumulation of Smoke Toxins: Qing dynasty’s Gu Songyuan stated: “Tobacco is the king of pungent, hot substances.” Long-term smoking burns body fluids, depletes yin, leading to lung yin deficiency, qi following yin deficiency. Additionally, tobacco toxins accumulate internally, lodge in lung orifices, obstruct airways, causing phlegm-dampness and blood stasis to coagulate into masses.
3. Invasion of External Pathogens: The lung is a delicate organ, easily invaded by pathogenic toxins such as industrial exhaust, asbestos, mineral dust, coal tar fumes, and radioactive substances. These disrupt lung qi’s descending function, cause qi stagnation, blood stasis, toxic stasis, and over time form masses.
4. Phlegm-Dampness Accumulating in the Lungs: The spleen is the source of phlegm, the lung the reservoir of phlegm. The spleen governs transportation and transformation. Spleen deficiency impairs transport and transformation, preventing proper distribution of food essence, leading to dampness accumulation and phlegm formation, lodging in the lungs. Poor diet leads to internal accumulation of water-dampness and phlegm, storing in lung networks, disrupting lung qi dispersion and descent. Phlegm stagnation blocks qi, leading to blood stasis, toxin retention, and accumulation in the chest, gradually forming masses.
In summary, lung cancer arises from deficiency of vital qi, imbalance of yin-yang, invasion of pathogenic toxins into the lungs, stagnation of pathogens in the lungs, disruption of lung function, impaired qi flow, blocked blood circulation, impaired fluid distribution, phlegm accumulation, phlegm-qi stagnation, blood stasis in collateral channels, and eventual adhesion of toxins and stasis forming lung masses. Thus, lung cancer is a disease characterized by overall deficiency and local excess. Deficiency is primarily yin deficiency or qi-yin deficiency; excess involves qi stagnation, blood stasis, phlegm coagulation, and toxin aggregation.
【Diagnosis】
1. Recent-onset paroxysmal cough, persistent dry cough for weeks, repeated hemoptysis, or unexplained persistent chest pain, dyspnea, fever, or weight loss, fatigue, etc.
2. Age over 40, male with long-term smoking history.
3. Sputum cytology is an important objective diagnostic method for lung cancer, with a positive rate around 80%, and repeated testing increases accuracy.
4. Chest X-ray, CT scanning, bronchial iodine oil angiography aid in early diagnosis.
5. Fiberoptic bronchoscopy determines lesion nature and is key for detecting early central-type lung cancer.
Additionally, for clinically suspected lung cancer cases where above tests fail to confirm, lung biopsy or timely thoracotomy exploration may be performed.
【Differentiation Principles】
1. Differentiate between Deficiency and Excess: Lung cancer often relates to lung qi deficiency and coagulation of phlegm-dampness and blood stasis. Early stage lung cancer mostly presents with qi stagnation, blood stasis, phlegm-toxin accumulation—predominantly excess. Late stage lung cancer mostly presents with yin deficiency and toxin heat, qi-yin deficiency—predominantly deficiency. Clinically, conditions are often complex, with mixed deficiency and excess.
2. Differentiate between Strength of Vital Qi and Pathogen: Lung cancer is a highly malignant tumor with rapid progression. Assessing the strength of vital qi versus pathogen is key to applying the principle of supporting vital qi and eliminating pathogen, and selecting appropriate formulas. Generally, when lung tumors and symptoms are obvious but the patient’s physique remains robust, with normal daily activities, appetite, and vitality, this indicates strong pathogen and relatively sufficient vital qi—active struggle between pathogen and vital qi. If widespread lung involvement or multiple metastases exist, with poor general condition, weight loss, fatigue, weakness, poor appetite, difficulty in daily activities, and complex symptoms, this indicates overwhelming pathogen and markedly deficient vital qi—deficiency with excess pattern.
【Treatment Principles】
Supporting vital qi and eliminating pathogen, treating both root and branch, is the fundamental approach. Overall, lung cancer is a deficiency condition, locally an excess condition. Deficiency is the root, excess is the branch. In early stages, excess dominates—treat by regulating qi, activating blood, resolving stasis, softening hardness, clearing heat, resolving phlegm, and detoxifying. In late stages, deficiency dominates—treat by supporting vital qi and eliminating pathogen, using methods such as nourishing yin and clearing heat, detoxifying and dispersing nodules, or tonifying qi and nourishing yin, clearing phlegm-heat. Clinically, treatment must consider mixed deficiency-excess patterns and individual patient conditions, managing urgency appropriately. Given that lung cancer patients have internal deficiency of vital qi, reduced anti-cancer capacity, and prominent deficiency, maintaining vital qi and protecting stomach qi must be prioritized throughout treatment.
【Differentiated Treatment】
1. Qi and Blood Stagnation
Symptoms: Unrelieved cough, chest tightness, breathlessness, fixed stabbing chest pain, dark red blood in sputum, cyanotic lips, dark tongue or ecchymosis, thin coating, fine wiry or fine涩pulse.
Treatment Principle: Activate blood circulation, resolve stasis, regulate qi, remove stagnation.
Formula: Tao Hong Si Wu Tang with additions. This formula uses Si Wu Tang to regulate blood and resolve stasis, combined with Peach Kernel, Safflower, Moutan Bark, Cyperus rotundus, Corydalis to activate blood, unblock collaterals, and relieve pain. For recurrent hemoptysis with dark red blood, add Persica, Lotus Node, Agrimony, Notoginseng, and Rubia Root to resolve stasis and stop bleeding. If stasis transforms into heat, injuring qi and fluids with dry mouth and dry tongue, add Adenophora, Trichosanthes root, Raw Rehmannia, Scrophularia, Anemarrhena to clear heat and nourish yin. For poor appetite, fatigue, shortness of breath, add Astragalus, Codonopsis, Atractylodes to tonify qi and strengthen the spleen.
2. Phlegm-Dampness Accumulating in the Lungs
Symptoms: Cough, expectoration, breathlessness, thick sticky sputum, white or mixed yellow-white, chest tightness and pain, poor appetite, loose stools, fatigue, dark tongue, white-yellow greasy or yellow thick greasy coating, wiry slippery pulse.
Treatment Principle: Regulate qi, resolve phlegm, strengthen spleen, dry dampness.
Formula: Er Chen Tang combined with Guallu Xiebai Banxia Tang. Er Chen Tang regulates qi, dries dampness, resolves phlegm. Combined with Guallu Xiebai Banxia Tang to enhance qi regulation, phlegm resolution, and chest broadening. For severe chest distension and cough, add Ting Li Da Zao Xie Fei Tang to drain lung fluid. For phlegm transforming into heat, yellow sticky sputum difficult to expel, add Sea Shell, Houttuynia cordata, Fritillaria root, Scutellaria baicalensis to clear phlegm-heat. For severe chest pain with evident stasis signs, add Turmeric, Ligusticum wallichii, Corydalis to resolve stasis and relieve pain. For fatigue and poor appetite, add Western Codonopsis, Atractylodes, Chicken Gizzard Membrane to strengthen spleen and aid digestion.
3. Yin Deficiency with Toxic Heat
Symptoms: Dry cough with little or no sputum, or blood in sputum, severe hemoptysis, chest pain, irritability, poor sleep, low-grade fever, night sweats, or intense fever persisting, thirst, constipation, red tongue, thin yellow coating, fine rapid or large rapid pulse.
Treatment Principle: Nourish yin, clear heat, detoxify, disperse nodules.
Formula: Sha Shen Mai Dong Tang combined with Wu Wei Xiao Du Yin. Ingredients include Adenophora, Ophiopogon, Wheat Winter, Glycyrrhiza, Mulberry Leaf, Trichosanthes root, raw Lablab bean to nourish yin and clear heat. Honeysuckle, Wild Chrysanthemum, Dandelion, Purple Flowered Groundsel, Purple Backed Skyflower clear heat and detoxify, disperse nodules. For persistent hemoptysis, add Raw Rehmannia, White Reed Rhizome, Agrimony, Rubia Root, Notoginseng to cool blood and stop bleeding. For constipation, add Trichosanthes fruit, Peach Kernel to moisten intestines and relieve constipation. For low-grade fever and night sweats, add Cortex Lycii, White Peony Root, Schisandra berry to nourish yin, clear heat, and arrest perspiration.
4. Qi-Yin Deficiency
Symptoms: Cough with little phlegm, or thin sticky sputum, weak cough, shortness of breath, fatigue, pale complexion, emaciation, aversion to wind, spontaneous sweating or night sweats, dry mouth with little drinking, red or pale tongue, fine weak pulse.
Treatment Principle: Tonify qi and nourish yin.
Formula: Sheng Mai Yin. This formula uses Codonopsis to tonify lung qi, Ophiopogon to nourish yin and generate fluids, Schisandra berry to collect and supplement lung fluids—three herbs together achieve tonifying qi, nourishing yin, and generating fluids.
If qi deficiency signs are prominent, add Astragalus, Prince’s Ginseng, Atractylodes to tonify lung and spleen. If yin deficiency predominates, add Northern Sand-Participate, Heavenly Winter, Scrophularia, Lily to nourish yin and increase body fluids. For difficult expectoration with little sticky phlegm, add Fritillaria, Trichosanthes, Apricot Kernel to clear lung and resolve phlegm. If lung-kidney dual involvement leads to yang deficiency due to yin depletion, add Epimedium, Morinda, Cistanche, Psoralea, etc., to warm and tonify kidney yang. In these syndromes, if upper vena cava compression syndrome occurs—manifesting as facial and upper chest cyanosis, edema, hoarseness, headache, dizziness, dyspnea, even coma—serious symptoms requiring immediate intervention. TCM treatment focuses on blood stasis and edema: activating blood, resolving stasis, diuresis, reducing swelling may alleviate symptoms in some patients. Common formulas include Tong Qiao Huo Xue Tang, Wu Ling San, Wu Pi Yin, Zhen Wu Tang. For milder compression symptoms, add ingredients like Ephedra, Poria, Raw Ephedra, Motherwort to clear lung congestion, activate blood, and promote diuresis. In long-term clinical research, certain commonly used anticancer herbs have been identified: Clearing heat and detoxifying herbs: Houttuynia cordata, Solanum nigrum, Euphorbia humifusa, Herba Hedyotis diffusa, Isatis leaf, Belamcanda chinensis, Sophora flavescens, Dandelion, Physostegia virginiana, Sarcandra glabra, Wild Chrysanthemum, Fritillaria, Stone Penetration, etc.; Phlegm-resolving and mass-dispersing herbs: Prunella vulgaris, Cremastra appendiculata, Bletilla striata, Smilax glabra, Radix Curcuma, Trichosanthes, Fritillaria, Pinellia, Apricot Kernel, Stemonae, Aristolochia, Littoralis, Smilax china, etc.; Blood-activating and hemostatic herbs: Frankincense, Myrrh, Peach Kernel, Great Burnet, Rhubarb, Pangolin Scale, Triangular Typhonium, Curcuma, Blue Perilla, Water Flaxseed, Clematis, Purple Gromwell, Corydalis, Turmeric, Sappanwood, Poppy, Stellera chamaejasme, Honeycomb, Notoginseng, etc.; Fluid-expelling herbs: Ephedra, Euphorbia pekinensis, Daphne genkwa, Phytolacca, Plantain Seed, Poria, Alisma, etc. These herbs with anticancer properties can be selected based on syndrome differentiation and specific patient conditions.
【Prognosis and Outcome】
Initially, toxins and phlegm-heat stagnate in the lungs, emphasizing excess patterns, with mild deficiency and strong vital qi. With proper treatment, the condition can improve. If uncontrolled, pathogenic toxins injure vital qi, leading to lung and spleen qi deficiency, weakening ability to resist pathogens. Pathogens may further spread beyond the lungs—into subcutaneous tissues, viscera, fascia, or joints and bones, eroding marrow and bone, or disturbing clear orifices, even obscuring them. Deficiency worsens, consuming qi and blood, injuring yin and yang. If signs like emaciation, muscle wasting ("great flesh completely wasted") appear, it often indicates imminent life-threatening stage. For some postoperative lung cancer patients who relapse, progression may shift from qi deficiency to yang deficiency, then to essence-blood deficiency. Clinically, this presents as combined qi-yin deficiency in lung, spleen, and kidney—indicating extremely severe disease with poor prognosis and poor treatment response. Furthermore, "phlegm-heat" is often a facet of lung cancer’s pathological evolution, primarily due to phlegm-stasis transforming into heat. The direct cause is tumor obstruction of bronchi, leading to poor sputum drainage and secondary infection. Once this transformation occurs, treatment must adopt a "cut-off" strategy to rapidly control heat and halt rapid deterioration.
【Prevention and Care】
Although there is currently no definitive preventive method, strengthening exercise, enhancing resistance, and avoiding long-term exposure to carcinogens can reduce incidence. Smoking is widely recognized as a major risk factor for lung cancer, so public education on smoking hazards and promotion of quitting are essential. Tar, coal tar, chromium, and other substances have carcinogenic potential and should be avoided or minimized. Ionizing radiation is also a risk factor, requiring protective measures. Patients should maintain cheerful mood, regular routines, fresh indoor air, and protection against cold to prevent secondary lung infections. Diet should avoid greasy, spicy, and stimulating foods; emphasize mushrooms, Job's tears, kelp, etc.