Cancers are populations of cells in the body that have acquired the ability to "spread" or metastasize, to distant sites via the blood and lymphatic circulation, thereby producing invasive tumors in other parts of the body.

Malignant tumors affect host functions by compression, invasion, and destruction of normal tissue and also by the elaboration of substances that circulate in the blood stream. The effects of a growing tumor in a patient may include fever, anorexia, weight loss, infection, anemia, and various hormonal and neurological symptoms. Both genetics and lifestyle are potent forces that influence the risk for developing cancer.

The western protocol for managing patients with cancer includes surgery, chemotherapy, radiotherapy and hormone replacement and hormone antagonists.

Many anti-cancer drugs, radiation, hormones, cytokines, transferred gene (gene therapy) exert their cytotoxic effects by inhibiting or disturbing the progression of cells through the cell cycle. The cell cycle involves the division of a single eukaryotic cell into two daughter cells via four biologically defended phases namely first gap (G1), DNA synthesis (S), second gap (G2) and mitosis (M). The cells may exist in a quiescent, non-proliferating state at G0 phase. The two main cell cycle effects of anti-cancer agents are:

1. exert a lethal or apoptotic effect which is maximal in a certain phase or phases of the cycle;

2. Affect the progression of cells through the cycle, by arresting cells at particular points in the cycle.

Although Chinese medicine is used in cancer treatment for several thousand of years, there is still no consistent opinion on their curative effects. Historically, the use of Chinese herbs has been the result of empirical clinical experiences rather than scientific merits.

Also, Chinese medicine is not prescribed based not on the disease entity but the overall symptoms, signs, and health status of the individual patient. The individualized prescription usually consists of a mixture of a number of herbs and other natural materials and such a formulation inevitably raise the question of standardization since the individual prescription usually consists of a mixture of a number of herbs and other natural products which is often decocted before being taken by the patient. Moreover, the multiple bioactive constituents in the natural compounds present another set of problems relating to quality control, accountability and safety measures.

In recent years, advancement in Chinese medicine has resolved a majority of such problems in the prevention and treatment of cancers. Several photochemicals with anti-tumor promoting potential have been investigated and verified. Many experimental studies evidence the protective mechanisms of TCM as agents in antioxidants, immunomodulation, enzymes inhibition, cell cycle arrest and the induction of apoptosis (cell death).

Traditional cancer treatments face numerous limitations: the principal aim of cancer chemotherapy is to kill tumor cells selectively without harming normal cells but this is rarely achieved.

A major problem is the limitation of anti-neoplastic drugs resulting from lack of sensitivity of the tumor and from toxicity to normal tissues.

Retroviral-mediated gene-labeling protocols have been approved for clinical studies that are designed to gain a better understanding of cancer disease progression and response to therapy but this field is at its infancy and there is belief that the considerable hurdles that must be overcome will lead to the failure of gene therapy. Some concerns includes the toxicity related to the use of adenovirus, the risks and side effects from transgenes, the lack of tumor-specificity of transgene expresssion, and the problem with efficient gene delivery to solid tumors.

With the development of modern sciences and biotechnology, we are now able to extract the effective ingredients of Chinese medicines and to study their anticancer mechanisms. Guided by the experience of TCM, many naturally occurring products from vegetables, herbs, fungi, animals and minerals have been considered to exert certain chemo-preventive and treatment properties against carcinogenesis based on scientific research by scientists. With advanced technologies such as high-performance liquid chromatography (HPLC), nuclear magnetic resonance (NMR), mass spectroscopy for isolation, separation and purification, gel electrophoresis, and DNA fingerprinting for species identification, a number of active components of Chinese medicine origin are now recognized for their immunomodulatory, anti-oxidative, enzymatic inhibitory and cell-cycle cytotoxic specific properties.

Studies have been conducted on anti-cancer drugs originating from plants and traditional medicines in China, with particular emphasis on camptothecin, tanshinone, taxol, daiden, acetyl boswellic acid, curcumin and ginsenoside. Some of these newly developed drugs such as camptothecin from Camptotheca accuminata and Taxol from Taxuss chinensis have been cited in western scientific literature as chemo-preventive and chemotherapeutic agents and are now actively administered in clinical applications.

Similar to many anticancer agents, active compounds of Chinese medicines are now known by their cell cycle specific effects. They can directly affect the cancer cells by either:-

(i) slowing down their proliferation, or
(ii) increase cell death by apoptosis (programmed cell death), or both.

The former can be achieved by arresting cells in the cell cycle phase such as G0/G1, S and G2/M, delaying cellular DNA synthesis, inhibiting the mitotic process, or interfering with the expression of cell cycle regulatory genes, oncogenes, or apoptotic genes. The latter can be achieved by direct induction of DNA strand break, interference of the metabolic process and suppression of the anti-apoptotic genes.

Many Chinese medicines have active compounds that are known to cause cell death in cancer cells by the induction of apoptosis i.e. through free radical formation, down-regulating the apopotic genes, affect hormones and ions transport, or cause DNA strands break. Apoptosis or "programmed cell death" represents a mode of cell death during which the cell activity participates in self-destruction. It has been identified by the internucleosomal DNA cleavage, which appears to be associated with endonuclease activation.

We have seen that the western approach to tumor treatment is unable to tackle all the heterogeneous cancer cells at once, often exerting side effects further damaging the disabled host's immunity and other vital organs because of their DNA-specificity. However, Chinese medicine does not offer any better an alternative when used in isolation owning to its weak cytotoxicity and non-specificity.

We believe that the combined therapy of both Eastern and Western medicine should be a superior protocol for cancer treatment - where western medicine managing the mainstream treatment protocol while Chinese medicine can exploited for its unique cell-cycle targeting immunomodulatory effect and anti-anorexic potential.