MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

I only recently came across this review; it was published a few years ago but is still highly relevant. It summarizes the evidence of controlled clinical studies of TCM for cancer.

The authors searched all the controlled clinical studies of TCM therapies for all kinds of cancers published in Chinese in four main Chinese electronic databases from their inception to November 2011. They found a total of 2964 reports (involving 253,434 cancer patients) including 2385 randomized controlled trials and 579 non-randomized controlled studies.

The top seven cancer types treated were lung cancer, liver cancer, stomach cancer, breast cancer, esophagus cancer, colorectal cancer and nasopharyngeal cancer by both study numbers and case numbers. The majority of studies (72%) applied TCM therapy combined with conventional treatment, whilst fewer (28%) applied only TCM therapy in the experimental groups. Herbal medicine was the most frequently applied TCM therapy (2677 studies, 90.32%). The most frequently reported outcome was clinical symptom improvement (1667 studies, 56.24%) followed by biomarker indices (1270 studies, 42.85%), quality of life (1129 studies, 38.09%), chemo/radiotherapy induced side effects (1094 studies, 36.91%), tumour size (869 studies, 29.32%) and safety (547 studies, 18.45%).

The authors concluded that data from controlled clinical studies of TCM therapies in cancer treatment is substantial, and different therapies are applied either as monotherapy or in combination with conventional medicine. Reporting of controlled clinical studies should be improved based on the CONSORT and TREND Statements in future. Further studies should address the most frequently used TCM therapy for common cancers and outcome measures should address survival, relapse/metastasis and quality of life.

This paper is important, in my view, predominantly because it exemplifies the problem with TCM research from China and with uncritical reviews on this subject. If a cancer patient, who does not know the background, reads this paper, (s)he might think that TCM is worth trying. This conclusion could easily shorten his/her life.

The often-shown fact is that TCM studies from China are not reliable. They are almost invariably positive, their methodological quality is low, and they are frequently based on fabricated data. In my view, it is irresponsible to publish a review that omits discussing these facts in detail and issuing a stark warning.

TCM FOR CANCER IS A VERY BAD CHOICE!

2 Responses to TCM for cancer? No, I would not recommend it

  • The review reveals most randomised TCM trials for cancer care in China, simply add TCM to conventional care and compare the result with conventional care alone. Placebo controls are very rare, being less than 1% of RCTs.

    One of these rarities, a placebo controlled RCT for breast cancer patients, was deemed to be “relatively well designed” (Liu HT 2009). It found:

    “two herbal medicine (sic) showed significant improvement of clinical symptoms, quality of life, immune function and one year, two year survival”.

    Unfortunately the original source is beyond my powers to locate on the internet. Nine years is a long time to have elapsed if these herbs were indeed superior to placebo. Is anyone doing the science, I wonder? That’s the only way we are really going to know if it’s true – and we need to know. Which, if any, are the relevant molecules?

    Do we have another Artemisinin? Or is it sufficient for the purpose of TCM to leave it there?

    Perhaps both.

    • I found another review by the same authors published in 2014: Impact of Chinese Herbal Medicine on Survival, Relapse and Metastasis in Women with Breast Cancer: A Systematic Review of Randomized Controlled Trial
      https://doi.org/10.1089/acm.2014.5162.abstract

      Their conclusion?

      The benefit of adding CHM to conventional treatments for improving survival, relapse and metastases in women with breast cancer remains unclear, and due to the limited number and methodological quality of studies, more rigorous RCTs are warranted.

      Situation normal.

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