Breast cancer is the second leading cause of cancer deaths in women today (after lung cancer) and is the most common cancer among women, excluding non-melanoma skin cancers. According to the World Health Organization, more than 1.2 million people will be diagnosed with breast cancer this year worldwide. The American Cancer Society estimates that in 2004, approximately 215,990 women in the United States will be diagnosed with invasive breast cancer (stages I-IV). Another 59,390 women will be diagnosed with in situ breast cancer, a very early form of the disease. Though much less common, breast cancer also occurs in men. An estimated 1450 cases will be diagnosed in men in 2004. A woman's lifetime chance of developing breast cancer is now listed as one in eight. There are four types of Western medical treatment for breast cancer currently considered standard: surgery, radiation, chemotherapy, and hormone therapy. Which treatment a woman will receive depends on her particular condition and personal wishes. However, treatment in most last-stage cases will include chemotherapy. Because chemotherapy is a systemic treatment affecting the cells in the entire body, it typically causes side effects, such as nausea and hair loss to name the two most infamous. In China, Chinese herbal medicinals are routinely used to manage and mitigate such chemotherapy side effects as well as to improve outcomes and increase length of life. In issue #5, 2004 on pages 270-272 of the Shan Dong Zhong Yi Za Zhi (Shandong Journal of Chinese Medicine), Wang Xing-chun et al. published an article titled, "A Clinical Study on the Treatment of Late Stage Breast Cancer with Xiao Chai Hu Tang (Minor Bupleurum Decoction) Combined with Chemotherapy." Because this study is indicative of how Chinese doctors are integrating traditional Chinese and modern Western medicines in the treatment of breast cancer, a summary of its main points is presented below.

[ILLUSTRATION OMITTED]

Cohort description

Altogether, there were 60 patients with late stage breast cancer enrolled in this study. These 60 patients were randomly divided into two groups, a so-called treatment group and a control or comparison group. All had been treated with surgery and had distant metastases. After surgery, all experienced recurrence or metastasis. These women's Karnvosky score was 60 points or more, and all had a three month or more projected survival time. Diagnosis and follow-up studies were carried out by X-ray, ultrasound, MRI, CT scan, and bone ETC. In the four weeks prior to the commencement of this study, none of the women had had any chemotherapy. Blood signs and liver and kidney function were normal, EKG was normal, and heart enzymes were basically normal. In terms of Karnovsky scores, pathology staging, TNM staging, sites of metastases, and whether the woman was receiving initial or repeat therapy, the women in both groups were statistically quite comparable. (These statistics were all included in the original Chinese article.)

Treatment method

Members of both groups received the CAF protocol. This consisted of 400mg/[m.sup.2] of cytotoxin (CTX) from days 1-8, 40mg/[m.sup.2] of adriomyacin (ADM) day one, and 300mg/[m.sup.2] of 5-flourouracil (5-FU) on days 2-5, with 21 days equaling one round of treatment. One week before the commencement of this protocol, the members of the treatment group also received Xiao Chai Hu Tang, which was continued through the length of this study. Xiao Chai Hu Tang consisted of:

Chai Hu (Radix Bupleuri)
Huang Qin (Radix Scutellariae Baicalensis)
Ban Xia (Rhizoma Pinelliae Ternatae)
Dang Shen (Radix Codonopsitis Pilosulae)
Da Zao (Fructus Zizyphi Jujubae)
Sheng Jiang
(uncooked Rhizoma Zingiberis Officinalis)
Gan Cao (Radix Glycyrrhizae Uralensis)

Seventy-eight point two grams of herbal medicinals were used to make each 200ml of medicinal liquid, and 200ml of this liquid were administered orally each time, two times per day (i.e., BID). Treatment was continued for three whole courses for both groups of patients.

Study outcomes

Study outcomes were based on WHO criteria for cancer. CR meant complete remission, i.e., complete disappearance of lesions within the area treated. PR meant partial remission or a more than 50% decrease in lesions within the treated area. NC meant no change, i.e., less than a 50% decrease or less than a 25% increase in lesions within the treated area, and PD meant a more than 25% increase of a lesion in treated area or new lesions within treated area. Based on these criteria, outcomes were divided between treatment and comparison groups and between those receiving initial treatment and repeat treatment. There were seven patients in the treatment group who received initial treatment. Of these, there were two CRs, four PRs, one NC, and no PDs, with a CR + PR rate of 85.7%. In the comparison group, there were nine cases receiving initial treatment. Among these, there was one CR, five PRs, one NC, and two PDs, with a Cr + PR rate of only 66.7%. In the treatment group, there were 23 patients who received repeat therapy. Of these, there were five CRs, 11 PRs, five NCs, and two PDs, for a CR + PR rate of 69.6%. In the comparison group, there were 21 cases who received repeat treatment. Among these, there were two CRs, eight PRs, six NCs, and five PDs, with a CR + PR rate of only 47.6%. Therefore, the combined Chinese-Western medical protocol was judged more effective than the chemotherapy alone (P + 0.05). Further, the mean remission time in the treatment group was 9.7 months as compared to only 6.9 months in the comparison group.