Abstract
Targeted cancer therapies, with specific molecular targets, ameliorate the side effect issue of radiation and chemotherapy and also point to the development of personalized medicine. Combination of drugs targeting multiple pathways of carcinogenesis is potentially more fruitful. Traditional Chinese medicine (TCM) has been tailoring herbal mixtures for individualized healthcare for two thousand years. A systematic study of the patterns of TCM formulas and herbs prescribed to cancers is valuable. We analysed a total of 187,230 TCM prescriptions to 30 types of cancer in Taiwan in 2007, a year's worth of collection from the National Health Insurance reimbursement database (Taiwan). We found that a TCM cancer prescription consists on average of two formulas and four herbs. We show that the percentage weights of TCM formulas and herbs in a TCM prescription follow Zipf's law with an exponent around 0.6. TCM prescriptions to benign neoplasms have a larger Zipf's exponent than those to malignant cancers. Furthermore, we show that TCM prescriptions, via weighted combination of formulas and herbs, are specific to not only the malignancy of neoplasms but also the sites of origins of malignant cancers. From the effects of formulas and natures of herbs that were heavily prescribed to cancers, that cancers are a ‘warm and stagnant’ syndrome in TCM can be proposed, suggesting anti-inflammatory regimens for better prevention and treatment of cancers. We show that TCM incorporated relevant formulas to the prescriptions to cancer patients with a secondary morbidity. We compared TCM prescriptions made in different seasons and identified temperatures as the environmental factor that correlates with changes in TCM prescriptions in Taiwan. Lung cancer patients were among the patients whose prescriptions were adjusted when temperatures drop. The findings of our study provide insight to TCM cancer treatment, helping dialogue between modern western medicine and TCM for better cancer care.
Highlights
According to the World Health Organization (WHO), cancer is the number one cause of mortality worldwide, accounting for 7.6 million deaths, or 13% of all deaths, across the globe in 2008 [1]
We focus on cancers by limiting the primary ICD-9 codes to be within 140 and 239, which are the codes allocated for neoplasms by the International Classification of Diseases published by the WHO
The top two cancer types explain the predominance of female Traditional Chinese medicine (TCM) patients in Taiwan
Summary
According to the World Health Organization (WHO), cancer is the number one cause of mortality worldwide, accounting for 7.6 million deaths, or 13% of all deaths, across the globe in 2008 [1]. The toll is expected to rise continuously to over 11 million in 2030. Environmental factors are believed to be a primary contributor to the pathogenesis. Other risk factors include smoking, alcoholism/diet, obesity, ageing and genetics. With mutated genomes, share three characteristics: uncontrolled cell multiplication, invasion of adjacent tissues, and migration to nonadjacent sites [2]. Metastasis of cancer, usually via bloodstream or lymphatics, to other vital organs such as lungs, liver, brain and bones adds to the malignancy and worsens the prognosis of the disease
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