[Cancer] Adding herbal medicine to chemotherapy for advanced lung cancer — raising quality of life while lowering side effects

Patients who have just been diagnosed with lung cancer and are about to begin chemotherapy are always afraid of one thing: whether they can endure the treatment to the end. Today let us look at one randomized controlled trial (RCT) that may help such patients.

Readers who have followed the earlier columns will by now be able to guess the conclusion without reading on. As we have confirmed again and again through many studies of herbal medicine in cancer care, this study too follows the same path.

Randomizing 68 patients, with quality of life as the primary endpoint

Published in 2021 in the international journal Medicine, this study randomized 68 patients with advanced non-small cell lung cancer (NSCLC), from stage IIIA through stage IV, into two groups. One group (36 patients) received platinum-based chemotherapy together with herbal medicine — Kang Ai injection (康艾注射液) along with decoctions and oral herbal formulas — while the other group (32 patients) received the same chemotherapy alone. The chemotherapy was identical in both groups, and the primary endpoint the researchers tracked from start to finish was not tumor size but the patient's own quality of life.

Quality of life rose significantly

Quality of life (QoL) was measured with a questionnaire standardized for lung cancer patients (FACT-L). At the second cycle of chemotherapy, the combination group's total QoL score was clearly higher than the chemotherapy-alone group's (P<0.001). Broken down by domain, emotional well-being (P<0.001), functional well-being (P=0.003) and social well-being (P=0.015) were all better in the combination group. In short, patients who added herbal medicine found the chemotherapy more bearable.

Thrombocytopenia: from three in ten to one in thirty

The difference in side effects was even sharper. Thrombocytopenia, a hallmark burden of chemotherapy, appeared in 28.13% of the chemotherapy-alone group at the second cycle, but in only 2.78% of the combination group (P=0.003). A drop in platelets that had struck nearly three patients in ten fell to about one in thirty. As a result, the combination group completed 100% of the planned chemotherapy, while the completion rate in the chemotherapy-alone group was 94.1%.

What about the tumor itself — an honest look

So what about the tumor itself? The disease control rate (DCR) — the proportion whose tumors shrank or at least did not grow — was 86.1% in the combination group versus 75.0% in the chemotherapy-alone group, but the difference was not statistically significant (the objective response rate, the proportion whose tumors actually shrank, was likewise 22.2% versus 25.0%, with no significant difference). In other words, in this study the power of herbal medicine lay not in 'shrinking the tumor further' but in 'helping the patient tolerate the treatment and see it through.' It shows the role precisely, without overstatement.

The wisdom in the prescription — supporting vital energy

What is worth noting is that the herbal medicine used here was not a prescription aimed directly at cancer cells. Kang Ai injection and the accompanying formulas were focused on bolstering energy and immunity and on restoring the functions that chemotherapy erodes. The strategy of Fuzheng Quxie (扶正祛邪) — building up the body's innate defenses so that it can bear treatment on its own — is confirmed once again here. Herbal medicine works because, before confronting the tumor head-on, it preserves the 'stamina' a patient needs to carry that fight through to the end.

In closing

This was a relatively small trial of 68 patients, and it carries the limitation of being an open-label study conducted without blinding. Nor did it prove tumor shrinkage or extended survival. Yet the fact that a randomized comparison points in the same direction as the earlier large observational studies — raising quality of life and lowering side effects — is far from trivial. Herbal medicine does not replace standard treatment; it stands alongside it, supporting the patient all the way through to the completion of that treatment. If you are undergoing or about to undergo chemotherapy for lung cancer, we encourage you to discuss it thoroughly with a specialist Korean medicine doctor and to pursue the herbal treatment best suited to you.