CAN Western medicine and Traditional Chinese Medicine (TCM) join hands to treat cancer patients?
If you asked Prof Li FuMin, a Singapore-based consultant TCM practitioner who specialises in immunology and oncology, the answer is yes. In fact, an integration of both techniques is more beneficial than using any of them alone, he says, but only if doctors from both sides talked to each other more often.
â€œBoth Western and TCM have their individual strengths and weaknesses. And cancer is a unique disease that neither of them can treat nor cure fully,â€ Li, 68, explains when met in Kuala Lumpur recently. â€œThat is why integrating the two might be more efficient in treating the disease.â€
Although his statement might appeal to conventional logic, barriers to an integrative approach in cancer treatment have thus far prevented it from becoming a widespread reality. The lack of communication and mutual trust between practitioners from both systems are among two of them.
â€œIn China, where Western medicine and TCM are deemed equal, and medical students from both systems are required to have basic knowledge of the other medical system, there is generally greater integration in the approach,â€ Li said. In other places, where complementary medicine is still regarded with a huge dose of scepticism, patients can find it more difficult to benefit from both systems.
â€œSometimes patients are told to completely avoid consuming traditional Chinese medicines when they are on conventional cancer treatment,â€ Li laments. But on the contrary, TCM can play a supportive role to cancer treatment, he added.
Elaborating on the way Western medicine and TCM are usually integrated in cancer treatment today, Prof Li offered: â€œUsually, patients will go through the conventional therapies like surgery, radiotherapy, and chemotherapy first before they go for TCM therapies.
â€œIt can act as a complementary therapy that could help alleviate some of the side effects of these cancer treatments, regulate patientsâ€™ body systems to improve their quality of life and prevent the recurrence of cancer once the disease is stabilised.â€
This is the way Li would suggest his patients go about it too. â€œAfter being diagnosed with cancer, many patients will consult many doctors, trained both in Western medicine and TCM. But I would always advise my patients to seize the opportunity to remove the tumour or go for chemotherapy or radiotherapy first.
â€œAfter that, TCM can help them with side effects and their recovery. It can also help reduce the chances of recurrence when taken long-term,â€ he explained.
The reason for this approach is a very practical one, because TCM practitioners could not diagnose cancer.
â€œThe claim that traditional Chinese medicine practitioners could diagnose cancer is a fallacy,â€ Li emphasised. First of all, many cancers have little or no symptoms until it reaches a late stage, which make diagnosis through the TCM way (observation of external symptoms and enquiries into a patientsâ€™ lifestyle) difficult, if not impossible.
Second, as TCM practitioners deduce the presence of a disease or ailments by relating certain groups of external symptoms to unhealthy changes inside the body, it is also difficult to diagnose a highly variable disease like cancer accurately.
â€œCancers can manifest in very different ways in individuals, and we now know that external symptoms may sometimes mislead us in our diagnosis,â€ Li said. â€œThat is why, to diagnose cancer, or other diseases, for that matter, we need to use modern diagnostic facilities,â€ he added.
Besides leaving the diagnosis to Western medicine, Li also stressed the importance of communication between attending doctors from both systems of medicine, particularly when a patient goes for conventional cancer treatment and TCM at the same time.
â€œWhen patients go for both treatments separately without informing their doctors about the other treatment, they may risk being repeatedly treated, over-treated, or mistreated. For instance, if you are about to go for a surgery, a traditional Chinese herb that increases your blood flow may cause you to bleed excessively during the procedure,â€ he said.
You would also be better off if you consult a TCM doctor who specialises in cancer treatment and understands conventional cancer treatment.
â€œIn cancer treatments, only when the TCM doctor understands his patientâ€™s condition and the procedures his patient had undergone completely will he be able to prescribe the best treatment to suit his patientâ€™s needs,â€ said Li, who also reads his patients medical records, X-rays and laboratory results when they are referred to him.
â€œAnd just like Western Medicine, TCM doctors can specialise in the treatment of certain diseases as well,â€ Li said.
In Malaysia, although there are efforts in integrating TCM and other traditional complementary medicine systems into public hospitals, the recognition of TCM as a complementary therapy for cancer treatment is still limited.
However, said Malaysian Oncological Society president Datuk Dr Mohd Ibrahim Wahid, many cancer patients undergoing treatment still seek alternative treatment, with or without their oncologistsâ€™ consent or knowledge.
â€œSo, even if we strongly oppose it, it doesnâ€™t help the total care of the patient,â€ he said.
And since his patients are going to go for alternative medicine like TCM anyway, he prefers to know about it. â€œIf (TCM) is used as a complementary therapy, and if it has no unsafe or untoward interactions with the treatments we are giving our patients, then we have no problems with that,â€ he said.
â€œWe are only concerned when patients rely solely on traditional treatments as an alternative to conventional treatment and delay appropriate treatment. This is because it will jeopardise our chances of curing or treating the cancer,â€ he added.
So, if cancer patients undergoing treatment are taking alternative medicine, Dr Ibrahim strongly advises them to inform their oncologists.
â€œEven when we are still not exactly sure how these medicines interact with conventional cancer treatment, we can monitor our patientsâ€™ condition with blood tests to ensure that their condition do not worsen as a result,â€ he says.
The way forward, as Dr Ibrahim sees it, is for oncologists to work together with TCM practitioners for the benefit of cancer patients. â€œWe canâ€™t say that Western medicine can cure every ailment, and we canâ€™t say that Chinese medicine can cure every ailment too.
â€œMaybe by working together, patients can have the best of both worlds and they can be reassured that we are doing the best we can to give them the best possible care,â€ he said.