An innovative approach to test Chinese herbal medicine using Western research methods has been devised by oncologists in Hong Kong to evaluate the role of herbal medicine in a conventional treatment programme.
Speaking at the European Society for Medical Oncology Congress in Nice, France, on Saturday, Dr Tony Mok from the Chinese University of Hong Kong said: "So many people in China are taking Chinese herbal medicine and we just don't know whether it is effective or safe to use at the same time as conventional medicine. We tend, therefore, to advise against it - but we should know for sure."
Chinese herbal medicine looks at the universal interaction between an individual and the environment and aims to maintain a balance in the Yin and Yang (harmony in the body) in order to preserve health and combat illnesses. There are around 250 types of common herbs to choose from and a combination of any of these will be prescribed to restore the balance. "It is a different concept to conventional medicine which is based on 'one drug for one disease'," he said.
For people with cancer, it is a common belief that Chinese herbal medicine could reduce the toxicity of chemotherapy. "A lot of people in Hong Kong and China go for that," said Dr Mok. The herbalist prescribes a mixture according to the condition of the patient, taking into account his observation on the patient's clinical status.
Because the concept of Chinese herbal medicine is different to Western medicine, they are difficult to compare but Dr Mok and his team found a way to assimilate research into both. The resulting study involves producing the herbal extract in a powder form, along with a placebo powder. The study is conducted according to Good Clinical Practice (GCP) Guideline, a universally accepted standard for clinical research in conventional medicine.
In this double-blind randomised trial, neither the herbalist, the conventional doctor nor the patients know whether they have been given the herbal extract or the placebo. The patients, while receiving standard adjuvant chemotherapy, were prescribed a combination of herbal extracts (or placebo) for reduction of chemotherapy-induced toxicity. Study endpoints also include treatment tolerance and quality of life. So far, 86 patients with either breast or colon cancer have been recruited into the trial. Dr Mok needs around 150 more people for the study.
Early results indicate a moderate reduction in symptoms such as nausea, vomiting or loss of appetite, said the researchers, although the comparative data will not be available until completion of trial. "We have already demonstrated the feasibility of capturing the information from clinical research on Chinese herbal medicine with this methodology," he said.
"And we could find something really useful that could point where we should look for better treatment," he added.
Dr Mok believes there are different ways to measure benefit. "Many doctors regard Chinese herbal medicine as a myth but it is based on a different philosophy to conventional therapies. Both sides need to compromise and be open-minded," he said.