Exploring the Use of Traditional Chinese Medicine in Oncology: A Review of Clinical Trials and Outcomes

Soo Youn^*
*Correspondence: Soo Youn, Department of Biology, Jeju National University, Jeju, Republic of Korea, Email:

Keywords

Oncology• Medicine• Traditional Chinese medicine

Introduction

Cancer is a leading cause of morbidity and mortality worldwide, necessitating ongoing efforts to improve treatment outcomes and quality of life for patients. Traditional Chinese Medicine (TCM) encompasses a range of practices, including herbal medicine, acupuncture and dietary therapy, which have been used for thousands of years to treat various ailments. In oncology, TCM is often used as a complementary approach to conventional treatments such as chemotherapy, radiation therapy and surgery. This article reviews clinical trials investigating the use of TCM in cancer care, highlighting key findings and future research needs.

Literature Review

Methods

A comprehensive literature search was conducted using databases such as PubMed, MEDLINE and Cochrane Library. Studies published between 2000 and 2023 were included to ensure the most recent evidence was reviewed. Keywords used in the search included "Traditional Chinese Medicine," "TCM," "cancer," "oncology," "clinical trials," "herbal medicine," "acupuncture," and "integrative medicine." Only peer-reviewed articles and systematic reviews were considered. The quality of the studies was assessed using established criteria, including study design, sample size and methodology [1].

Results

Herbal medicine

Herbal medicine is a cornerstone of TCM, often used to alleviate symptoms and enhance the efficacy of conventional cancer treatments.

1. Ginseng: Ginseng is one of the most studied TCM herbs in oncology. A 2018 meta-analysis in the journal Oncotarget reviewed randomized controlled trials (RCTs) involving ginseng in cancer patients. The analysis found that ginseng supplementation improved fatigue, quality of life and overall survival rates in patients undergoing chemotherapy and radiotherapy.
2. Astragalus: Astragalus membranaceus is another commonly used TCM herb. A 2019 systematic review and meta-analysis in Frontiers in Oncology evaluated the effects of astragalus-based therapies in cancer patients. The review included 26 RCTs and concluded that astragalus significantly improved immune function, reduced chemotherapy-induced toxicity and enhanced quality of life.
3. Tripterygium wilfordii: Known for its anti-inflammatory and immunosuppressive properties, Tripterygium wilfordii has shown promise in cancer treatment. A 2020 study in Phytotherapy Research found that Tripterygium extracts, when combined with conventional chemotherapy, improved response rates and reduced tumor progression in patients with solid tumors.

Acupuncture

Acupuncture is another key component of TCM, widely used to manage cancer-related symptoms such as pain, nausea and fatigue.

1. Pain management: A 2017 Cochrane review evaluated the effectiveness of acupuncture for cancer pain. The review included 13 RCTs and found that acupuncture significantly reduced pain intensity and opioid consumption in cancer patients compared to placebo or no treatment.
2. Nausea and vomiting: Acupuncture has been shown to be effective in reducing chemotherapy-induced nausea and vomiting. A 2018 RCT published in the Journal of Clinical Oncology demonstrated that acupuncture significantly decreased the frequency and severity of nausea and vomiting in breast cancer patients undergoing chemotherapy.
3. Fatigue: Cancer-related fatigue is a common and debilitating symptom. A 2020 meta-analysis in Supportive Care in Cancer reviewed the effects of acupuncture on cancer-related fatigue, including 14 RCTs. The analysis concluded that acupuncture significantly reduced fatigue levels and improved patients' physical functioning [2].

Integrative approaches

The integration of Traditional Chinese Medicine (TCM) with conventional cancer treatments has gained increasing recognition for its potential to enhance therapeutic outcomes, improve quality of life and provide comprehensive care for cancer patients. Integrative oncology combines the best of both worlds, utilizing the strengths of conventional therapies alongside complementary approaches to achieve synergistic effects [3].

Combination therapies

Integrative oncology often involves the use of TCM in conjunction with conventional cancer treatments such as chemotherapy, radiation therapy and surgery. This approach aims to enhance the efficacy of conventional treatments while mitigating their side effects.

1. Improved survival rates: A 2019 study published in the Journal of Integrative Oncology investigated the effects of combining TCM with conventional chemotherapy in patients with advanced non-small cell lung cancer. The study found that patients receiving the combined treatment had significantly higher overall survival rates and better quality of life compared to those receiving chemotherapy alone. The TCM regimen included herbal formulations known for their immune-modulating and anti-inflammatory properties, which were believed to enhance the effectiveness of chemotherapy and support overall health.
2. Reduced treatment-related toxicity: Another study in the Journal of Cancer Research and Clinical Oncology (2020) evaluated the impact of combining TCM herbal medicine with radiation therapy in patients with head and neck cancer. The results showed that patients who received the integrative treatment experienced fewer side effects, such as mucositis and xerostomia, compared to those who received radiation therapy alone. The herbal medicine was thought to protect normal tissues and enhance tissue repair processes.

Supportive care

TCM is frequently used in supportive care to manage side effects of conventional cancer treatments, improve patients' quality of life and address psychological and emotional aspects of cancer care [4].

1. Management of chemotherapy-induced nausea and vomiting (CINV): A 2018 systematic review in the Journal of Clinical Oncology examined the efficacy of acupuncture in managing CINV. The review included multiple RCTs and found that acupuncture significantly reduced the frequency and severity of CINV in cancer patients compared to standard antiemetic drugs alone. Acupuncture was proposed to modulate neurochemical pathways involved in nausea and vomiting, offering a non-pharmacological alternative for symptom management.
2. Fatigue and quality of life: A 2021 systematic review in Integrative Cancer Therapies assessed the role of TCM, including herbal medicine and acupuncture, in managing cancer-related fatigue. The review highlighted that TCM therapies effectively reduced fatigue levels, improved physical functioning and enhanced overall quality of life for cancer patients. The mind-body components of TCM, such as tai chi and qigong, were particularly noted for their benefits in reducing stress and promoting relaxation.
3. Psychological support: TCM approaches often emphasize holistic care, addressing not only physical symptoms but also psychological and emotional well-being. A 2017 study in Psycho-Oncology explored the effects of mindfulness-based stress reduction (MBSR), a mind-body therapy rooted in TCM principles, on anxiety and depression in cancer patients. The study found that MBSR significantly reduced anxiety, depression and stress levels, enhancing patients' emotional resilience and coping mechanisms.

Mechanisms of action

The mechanisms by which TCM exerts its beneficial effects in oncology are complex and multifaceted, involving various biological, immunological and psychological pathways [5,6].

1. Immune modulation: Many TCM herbs, such as astragalus and ginseng, have been shown to modulate the immune system, enhancing immune surveillance and improving the body's ability to fight cancer. These herbs can increase the activity of natural killer (NK) cells, T cells and other immune components critical for targeting cancer cells.
2. Anti-inflammatory effects: Chronic inflammation is a known contributor to cancer progression. TCM herbs like Tripterygium wilfordii and Scutellaria baicalensis possess strong anti-inflammatory properties that can inhibit pro-inflammatory cytokines and pathways, thereby reducing cancer-related inflammation and potentially slowing tumor growth.
3. Antioxidant properties: Oxidative stress plays a significant role in cancer development and progression. Many TCM herbs contain potent antioxidants that can neutralize free radicals, protect cells from oxidative damage and improve overall cellular health.
4. Stress reduction and psychological well-being: Mind-body therapies in TCM, such as acupuncture, tai chi and qigong, can reduce stress, improve mental health and enhance overall well-being. These therapies are believed to work through the modulation of the autonomic nervous system and the regulation of stress hormones, promoting a state of relaxation and balance.

Future research directions

To further validate the integration of TCM in oncology, future research should focus on:

1. Large-scale clinical trials: Conducting large, high-quality randomized controlled trials to establish the efficacy and safety of integrative treatments across different types of cancer and stages of disease.
2. Mechanistic studies: Investigating the specific biological mechanisms through which TCM therapies exert their effects, including their impact on immune function, inflammation and oxidative stress.
3. Standardized protocols: Developing standardized treatment protocols that integrate TCM with conventional therapies, ensuring consistency and reproducibility in clinical practice.
4. Patient-centered research: Exploring patient experiences, preferences and quality of life outcomes to better tailor integrative approaches to individual needs and improve overall patient care.

Discussion

The use of TCM in oncology has shown promising results in improving symptom management, quality of life and survival outcomes. However, the variability in study design, quality and heterogeneity of TCM practices poses challenges in drawing definitive conclusions. Further high-quality, large-scale clinical trials are needed to validate these findings and establish standardized protocols for integrating TCM into conventional cancer care.

Future research directions

Future research should focus on:

1. Mechanistic studies: Investigating the biological mechanisms underlying the effects of TCM therapies in cancer treatment.
2. Standardized protocols: Developing standardized treatment protocols for the use of TCM in oncology to ensure consistency and reproducibility.
3. Long-term outcomes: Assessing the long-term efficacy and safety of TCM therapies in cancer care.
4. Patient-centered research: Exploring patient preferences, experiences and quality of life outcomes to better tailor integrative approaches to individual needs.

Conclusion

Traditional Chinese Medicine offers a promising complementary approach to conventional oncology, with evidence supporting its efficacy in symptom management, improving quality of life and enhancing survival rates. While current research highlights the potential benefits of TCM, further rigorous studies are needed to establish its role in integrated cancer care. By combining the strengths of both conventional and TCM therapies, healthcare providers can offer more holistic and patient-centered care for cancer patients.

Acknowledgement

None.

Conflict of Interest

There are no conflicts of interest by author.

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