Surgery remains as one of the primary forms of cancer treatment. Nearly all cancer patients will have some kind of surgery, whether it is used to perform a biopsy to confirm the diagnosis, provide local treatment, or obtain other information to help determine whether additional treatment is necessary. However, a lengthy healing process is always needed because of the invasiveness of the procedure. Appropriate preparations before and after surgery is the best way to help the process go smoothly. From a TCM perspective, surgery will unavoidably lead to damage by further exhausting blood and qi, and causing internal disharmony as well. TCM tonifying methods help to buildup the body constitution so as to reduce the risks associated with surgery. Preparation before surgery Generally, TCM tonifying methods have to start one or two weeks prior to surgery; they aim at improving general physical strength as well as the specific cancer condition so as to help surgeons to cut away the cancerous tissues as much as possible. Patients are usually treated with the classic prescriptions, which are well known for replenishing blood and qi, and nourishing the liver and kidneys. Classic prescriptions include:

• Four-gentlemen Decoction (si jun zi tang)
• Four-substance Decoction (si wu tang)
• All-inclusive Great Tonifying Decoction (shi quan da bu tang)
• Six-ingredient Pill with Rehmannia (liu wei di huang tang)
• Restore the Spleen Decoction (gui pi tang)

After surgery, when the patients are allowed to eat, physicians usually focus on various other symptoms and helping the patients to prepare for further radio or chemotherapy. Management after surgery

• Regulating spleen and stomach

Due to anesthesia, bleeding and surgical trauma, the patients' spleen and stomach are always affected. It is common to see symptoms like poor appetite, abdominal distention, constipation, nausea and vomiting. If symptoms are mild, a prescription such as Costus and Amomum with Six Noble Ingredients Decoction (xiang sha liu jun zi tang) is used. If individuals have obvious abdominal distention, constipation, mouth dryness and thick yellow tongue coating, that means there exists qi stagnation and heat accumulated inside the organs. The prescription should also add:

zhi qiao	Bitter orange peel	Fructus Aurantii
hou po	Magnolia bark	Cortex Magnoliae Officinalis
mu xiang	Costus root	Radix Aucklandiae
da huang	Chinese rhubarb	Radix et Rhizoma Rhei

 

Bitter orange peel

Magnolia bark

Costus root

In case general weakness is significant, then certain tonifying herbs are added, such as:

ren shen	Ginseng	Radix Ginseng
huang qi	Astragalus	Radix Astragali
gan cao	Liquorice root	Radix Glycyrrhizae
ji nei jin	Chicken's gizzard-skin	Endothelium Corneum Gigeriae Galli
chen pi	Tangerine peel	Pericarpium citri Reticulatae

• Replenishing qi and consolidating body surface

  For some surgical patients, even simple physical activity (or none at all) can easily induce sweating. TCM considers this a morbid condition due to an exterior deficiency (biao xu) or heart deficiency, which makes the individuals susceptible to infections or sleeping problems. A prescription called Jade Windscreen Powder (yu ping feng san) can be employed, some other commonly used herbal ingredients are:

huang qi	Astragalus	Radix Astragali
bai shao	White peony root	Radix Paeoniae Alba
fang feng	Ledebouriella root	Radix Ledebouriellae
fu xiao mai	Shriveled wheat	Fructus Tritici Levis
tai zhi shen	Heterophylly Falsestarwort root	Radix Pseudostellariae
wu wai zi	Schisandra	Fructus Schisandrae

Ledebouriella root

Heterophylly Falsestarwort root

Shriveled wheat

• Nourishing yin to promote body fluid production and reconstruction

When patients suffer from severe mouth dryness, deep red tongue without any coating, dry stool, no appetite or nausea, in TCM, they are suffering from body fluid exhaustion and damage to stomach yin. A higher dose of herbs are prescribed such as:  

nan sha shen	Fourleaf ladybell root	Radix Adenophorae Strictae
bei sha shen	Coastal Glehnia root	Radix Glehniae
mai dong	Dwarf lily-turf	Radix Ophiopogonis
tian hua fen	Snakegourd root	Radix Trichosanthis
yu zhu	Fragrant Solomonseal rhizome	Rhizoma Polygonati Odorati
sheng di	Rhemannia rhizome	Rhizoma Rehmanniae

 

Fourleaf ladybell root

Coastal Glehnia root

Fragrant Solomonseal rhizome

Long-term rehabilitation with Chinese medicines Thereafter, for long-term rehabilitation, TCM tonifying methods should be used with some expelling methods like anti-cancer herbs as mentioned previously. For example, lung cancer associated with yin deficiency should mainly enrich the yin and moisten the lungs; however, when it is associated with phlegm and dampness retention, it should also disperse phlegm to soften lumps. In general, tonifying methods like enhancing the spleen and harmonizing the stomach are used for digestive tumors; soothing the liver and regulate the qi is used in breast cancers. These methods help to prevent the recurrence of cancer at a later date.