Challenges and opportunities of applying P4 medicine and traditional Chinese medicine for cancer treatment and prevention in the 21st century: A medical oncologist’s perspectives

Abstract

Highlights：

Being one of the deadliest diseases with ever-rising incidence especially in China, cancer is a major health threat and drains the patients, their families and society more resources than all other diseases. This overview on colorectal cancer treatment and prevention intends to rally principle-based P4 medicine (predictive, preventative, personalized and participatory) practice and best of traditional Chinese medicine on pre-illness and disease prevention and treatment to lead 21st century consumer driven health care and network movement facilitated by inevitable digital revolution and artificial intelligence use in every day’s life.

Abstract

Being one of the deadliest diseases, cancer needs a stronger dose of P4 medicine (Predictive, Preventive, Personalized and Participatory) first proposed by Dr. Hood and TCM intervention, as cancer treatment still largely relies on the decade-old cytotoxic chemotherapy, radiation and surgery. This overview uses colorectal cancer model to discuss pitfalls in current cancer prevention and treatment strategies, which saw many randomized phase III studies failing to meet the study primary endpoints or marginally meeting the study objectives. Complete sequencing of whole human genome provided much of the hopes as well as hypes for precision medicine, as genomic diversity, ever changing tumor mutation landscape, SNP and complex microRNA regulation from the intron region and epigenetics make genotype to phenotype correlation study increasingly challenging. As a participant of One hundred Persons Pioneers Project, I witnessed first hand how a comprehensive scientific wellness study that integrates whole genomics, microbiome, and metabolome nutrition along with comprehensive laboratory examinations can be used to diagnose pre-illness in all “healthy” participants. Pre-illness can be best intervened by none pharmaceutical means and traditional Chinese Medicine (TCM) adept in restoring internal healing mechanisms, opening up the blocked network and balancing the five-elements homeostasis. Following TCM principles, we were able to design a therapy that effectively targets colon cancer stem cells and its microenvironment leading to more doubling of overall survival with reduction in overall toxicities. Pre-illness diagnosis, cancer immunotherapy, TCM medicine is about restoring internal healing power by letting go brakes on “good” immune systems to go after the “bad” cancer cells. Time is ripe to integrate our knowledge in genomics immune systems, stem cell biology, nutrition, inflammation, metabolism, systems medicine, and modern TCM to deliver a level of care that most of major illness including cancer are now minor pre-illness and are delayed, prevented, or cured at their earliest stages along with elevation in healthy index in the individual, their families and society as a whole globally.

Translated abstract

癌症作为最致命的疾病之一,其治疗在很大程度上仍然沿用着数十年前就出现的化疗、放疗、手术等方式,因此迫切需要更多地P4医学以及传统中医的干预,P4医学由Hood博士最先提出,是一种预测性、预防性、个性化和参与性相结合的医学概念。鉴于许多随机III期临床研究无法满足其主要研究终点或者只能勉强达到研究目标,因此本综述利用结直肠癌模型来讨论当前癌症预防和治疗策略中存在的误区。人类全基因组测序的完成为精准医学带来了很大的希望,同时也带来了大量的宣传炒作。基因组多样性、不断变化的肿瘤突变形势、SNP、源于基因内含子区域的复杂microRNA调控、表观遗传学等这些因素,都使得基因型与表型的相关性研究变得越来越具挑战性。作为100先锋项目的一名参与者,我亲眼目睹了这个项目是如何为所谓“健康”的参与者诊断未病的过程。100先锋项目是一个全面、科学的健康研究项目,该项目包含了全基因组学、微生群落学、营养学以及全面的实验室检查等研究手段。非药物疗法和传统中医能够对未病产生很好的干预效果,传统中医擅长于恢复人体内部的自愈机制、打开人体闭塞的经络以及平衡人体的五行。根据传统中医的原则规律,我们设计了一种疗法,这种疗法能够有效地对结肠癌干细胞及其所处的微环境产生靶向作用,使患者总生存期提高一倍多,并且降低总体药物的毒副作用。未病的诊断、癌症免疫疗法、传统中医都是通过对“好”的免疫系统放开限制,让其去追捕人体“坏”的癌细胞,从而恢复人体内部的自愈能力。是时候将基因组学、免疫学、干细胞生物学、营养学、炎症研究、代谢学、系统医学和现代中医学等知识融合在一起了。这样我们就能达到一个新的医疗护理水平,使得包括癌症在内的大部分重大疾病、以及轻微的未病在早期就能得到推迟、预防或治愈,同时在全球范围内实现个人、家庭和社会整体健康指数的提高。