Last week, a woman in her forties came to my outpatient clinic. She had been diagnosed with mid-stage ovarian cancer — a diagnosis that came as a complete shock, given that her work and daily life had been entirely normal. The only clue was a blood-tinged vaginal discharge that had persisted for about two weeks. A hospital examination revealed a 4 cm polyp on her cervix; pathology confirmed moderately differentiated adenocarcinoma, and the hospital recommended surgery as soon as possible.

However, this lady was deeply reluctant to undergo surgery. Against enormous pressure from her family, she came to my clinic seeking Traditional Chinese Medicine (TCM) treatment. After a thorough evaluation — inspection, listening, questioning, and pulse diagnosis — I found her in reasonably good condition overall. The tumor was localized, with no pelvic effusion. She had a reddish-white discharge with a heavy, fishy odor; a sallow complexion; a tongue that was pink with a reddish tint and a thin yellow coating; and a wiry-slippery pulse with weak proximal (chi) positions and sunken distal (cun) positions. This was a fairly classic presentation of spleen-kidney deficiency with a destabilized Dai vessel and internal accumulation of damp-heat — a pattern amenable to TCM treatment.

That said, in the spirit of scientific rigor: she no longer had any need to preserve fertility, there was no metastasis, her mental state was good, and everyone around her was urging Western medical treatment. Under these circumstances, I felt the safest course was surgery first — but without chemotherapy or radiation — followed immediately by Chinese herbal medicine. This approach would essentially preserve quality of life, offer virtually no risk of recurrence, and minimize any impact on longevity. It was the safest, most convenient, and most reliable option available.

Of course, I could not make the decision for her; I could only lay out the pros and cons. If it had been me, I probably would have opted for TCM — after all, nobody wants to be cut open, and losing a part of your body never feels quite right. Seeing her hesitation and hearing her family continue to urge surgery, I said no more. I wrote out a prescription and let her go home to decide for herself whether to take it.

Four days later, she told me that she had filled the prescription the very day she got home. By the third day, she had passed some blood clots. She still had some discharge, but the odor was gone. She went back to the hospital for a repeat tumor marker panel, and her CA-125 had already dropped from 44 to 35. Yet, under the persistent persuasion of her family, she ultimately decided to be admitted for surgery.

I understand — faced with this situation, few people would gamble with their lives. In today’s world, where Western medicine dominates the narrative, TCM struggles to have its voice heard. And admittedly, TCM’s own unreliability bears direct responsibility for that marginalization. So how should cancer patients choose a treatment plan? Here is my thinking:

1. For early- or mid-stage tumors where surgery is feasible, operate promptly, then bring in TCM right away — skip the chemotherapy and radiation. These only erode quality of life, and long-term outcomes are inferior to those achieved with TCM. Special situations should be considered: for example, a young woman with a gynecological tumor may opt for TCM if circumstances permit, with a good chance of nipping the tumor in the bud and avoiding the permanent regret of surgical removal.

2. For mid- to late-stage disease, assess overall health. If the patient is in good condition, operate early. Post-surgery, a short course of chemotherapy or radiation may be appropriate, but Chinese herbal medicine should be introduced concurrently. If the response is favorable, stop chemo/radiation as soon as possible and persist with herbal treatment. Current clinical research suggests this approach can substantially improve quality of life and five-year survival rates.

3. For advanced disease with a very poor prognosis, or when surgery is not an option, TCM should be initiated early. Once these patients enter the hospital cycle of chemotherapy and radiation, most survive no more than three months. A few with robust constitutions may last longer, but the entire process is excruciating. In developed countries, widely metastatic malignancies are generally not treated surgically; chemotherapy is the mainstay. In essence, chemotherapy and TCM share a similar fundamental approach — but for most people, chemotherapy is far more painful, while Chinese herbal medicine is gentler and safer.

4. Diseases vary, and modern medicine has excellent tools for many conditions. When chemotherapy is indicated, use chemotherapy; when radiation is indicated, use radiation. Treatment plans must be grounded in a deep understanding of the specific disease. Neither TCM nor Western medicine should be demonized.

5. If you choose TCM, you must find a reputable, trustworthy practitioner. Charlatans abound, and many hospital-based TCM doctors have been Westernized to the point of losing their traditional perspective. The sorry state of TCM today is directly attributable to the recklessness of those who practice it without competence.

上周门诊来了一位卵巢癌中期的患者，40多岁，工作生活正常，可以说毫无征兆，只是因为半个月前开始一直有血色白带流出，经医院一检查才发现宫颈中长了一个4cm的息肉，病理检查为中分化腺癌，医院通知尽早手术。

不过这位女士十分珍惜自己的身体，不愿意手术，顶着家中极大的压力来到门诊，欲求中医治疗。经过一番望闻问切，我发现她当前状态良好，肿瘤范围比较局限，盆腔尚无积液，赤白带下，味道腥重，脸色偏黄，舌质粉中带红，舌苔薄黄，脉象弦中偏滑，两尺弱，两寸沉，比较典型的脾肾不足，带脉失约，湿热内蕴之证，应该是可以中医治疗的。

但是本着科学的精神，既然已经没有了生育的需求，在没有转移，精神状态良好，周围环境要求西医治疗的情况下，我认为最稳妥的方案还是先手术，不要放化疗，手术后直接中药治疗最佳，这种方案基本上不影响生活质量，几乎没有复发可能，而且对寿命损伤最少，最安全最方便最可靠。

当然，我是不能替她决定的，只能分析利害关系，不过如果是我自己得病的话，这种情况下应该选择中医治疗的，毕竟我也不愿意挨一刀，身上少点什么东西总是不好受的。当时我看她犹豫不决，周围人又劝她回去手术，就没再说什么，开了张药方让她回家自己决定吃或者不吃。

过了四天，她告诉我说回家就抓药吃了，吃到第三天排出了一些血块，现在还有些白带，但是已经没有味道了，今天去又去测了肿瘤四项，发现CA125已经从44降到了35，但是架不住亲人的循循善诱，还是决定去住院手术了。

我想，任何人遇到这种情况都不会拿生命做赌注，在西医强势当道的今天，中医已经难以掌握话语权，当然这与中医的不可靠性也有直接的关系。癌症患者究竟应该选择怎样的治疗方案呢，我是这么觉得的：

1、如果是肿瘤早期，或者中期，能手术的抓紧手术，手术完直接中医介入，不要再做放化疗了，这样只会降低生活质量，远期效果不如中医好。有些特殊情况要考虑，比如说年轻人得了妇科肿瘤，如果情况允许，还是可以选择中医治疗的，有很大几率将肿瘤扼杀在摇篮之中，以免一刀下去，终身遗憾。

2、如果是中晚期，要看身体情况，身体状态好的，应该尽早手术，手术后看情况可以先进行几次放化疗，同时中药介入，如果情况不错，应该及早停止放化疗，坚持中药治疗，根据现有的临床研究可以极大提高生活质量，提高五年生存率。

3、如果是晚期预后极差的，或者不能手术的，应该及早进行中药治疗，这类病人进入医院放化疗后基本上不会超过三个月，个别身体好的能存活较长时间，但是整个过程都非常痛苦。在发达国家，如果是已经多处转移的恶性肿瘤，一般不主张手术治疗，而是以化疗为主。其实化疗和中医药疗法本质上差不多，对于大多数人来说化疗的过程更痛苦，而中药更加安全平和。

4、由于病情不同，许多疾病现代医学有非常好的办法，该化疗的时候应该化疗，该放疗的时候应该放疗，必须本着对该病的深刻认识妥善选择治疗方案，不能妖魔化中医或者西医。

5、选择中医诊疗必须要找有口碑的靠谱的好医生，现在江湖游医众多，医院中被西化的中医也很多，中医之所以现在沦落到如此地步与这些人的胡作非为草菅人命脱不开关系。