摘要：本文旨在探讨中晚期癌症患者过度放化疗的潜在危害，并结合化疗的广泛副作用进行分析。通过对化疗副作用的详细归纳，本文提出对于中晚期癌症患者而言，过度依赖放化疗可能不仅无法显著提高治疗效果，反而可能加剧患者身体负担，降低生活质量。中医治疗虽能缓解部分毒副作用，但面对
摘要
本文旨在探讨中晚期癌症患者过度放化疗的潜在危害，并结合化疗的广泛副作用进行分析。通过对化疗副作用的详细归纳，本文提出对于中晚期癌症患者而言，过度依赖放化疗可能不仅无法显著提高治疗效果，反而可能加剧患者身体负担，降低生活质量。中医治疗虽能缓解部分毒副作用，但面对持续化疗带来的庞大复杂健康问题，其效果有限。因此，本文建议中晚期癌症患者应综合考虑治疗方案的利弊，避免过度放化疗，以期在保障患者生活质量的基础上，实现更为合理的治疗选择。
中晚期癌症、放化疗、副作用、生活质量、中医治疗
引言
癌症作为威胁人类健康的重大疾病之一，其治疗方法的选择一直是医学界关注的焦点。对于早期癌症患者，手术往往是首选治疗方案，而对于中晚期患者，放化疗及靶向治疗等则成为重要的治疗手段。然而，随着治疗进程的深入，放化疗的副作用逐渐显现，尤其是对中晚期患者而言，过度放化疗可能带来的身体损害不容忽视。本文将从化疗副作用的角度出发，探讨中晚期癌症患者不建议过度放化疗的合理性。
正文
一、中晚期癌症治疗现状与挑战
中晚期癌症患者面临的治疗挑战在于肿瘤已经发生局部或远处转移，单纯手术切除难以彻底根治。因此，放化疗及靶向治疗等成为重要的辅助治疗手段。然而，这些治疗方法在杀灭癌细胞的同时，也会对正常细胞造成损害，从而引发一系列副作用。
二、化疗的广泛副作用
化疗作为一种常见的抗肿瘤疗法，其副作用广泛且复杂。根据梁世杰科研团队的梳理，化疗的副作用至少包括50条以上，涵盖了消化系统、血液系统、免疫系统、神经系统等多个方面。以下是对化疗副作用的详细归纳：
1. 消化系统症状：恶心、呕吐、食欲减退、腹泻、便秘、腹胀、腹痛、胃胀、口腔溃疡等。这些症状直接影响患者的进食和营养吸收，导致营养不良和体重下降。
2. 血液系统症状：白细胞减少、血小板减少、贫血、红细胞减少等。这些症状可能增加患者感染的风险，同时影响凝血功能，导致出血倾向。
3. 免疫系统症状：易感染、发热、寒战等。化疗导致免疫系统受损，使患者更容易受到病原体的侵袭。
4. 神经系统症状：手脚麻木、手脚疼痛、记忆力减退、神经毒性等。这些症状可能影响患者的日常生活和认知功能。
5. 其他系统症状：乏力、疲劳、脱发、色素沉着、皮疹、过敏反应等。这些症状不仅影响患者的外貌和自信心，还可能引发心理问题。此外，化疗还可能导致心脏毒性、肝脏毒性、肾脏毒性等，对患者的内脏器官造成损害。
三、过度放化疗对中晚期癌症患者的危害
对于中晚期癌症患者而言，过度放化疗可能带来以下危害：
1. 加剧身体负担：中晚期癌症患者本身身体状况较差，过度放化疗可能进一步加剧身体负担，导致患者身体状况恶化。
2. 降低生活质量：化疗的副作用严重影响患者的日常生活，如恶心、呕吐、腹泻等症状可能导致患者无法正常进食；乏力、疲劳等症状可能影响患者的日常活动能力。这些副作用不仅降低患者的生活质量，还可能引发心理问题，如焦虑、抑郁等。
3. 影响治疗效果：过度放化疗可能导致患者对治疗的耐受性下降，从而影响治疗效果。同时，化疗药物在杀灭癌细胞的同时，也对正常细胞造成损害，导致机体免疫力下降，增加感染风险。
四、中医缓解化疗毒副作用的有限性
虽然中医强调整体观念和个体化治疗，且中医药在缓解放化疗副作用方面具有一定的优势，但面对化疗带来的庞大复杂健康问题，其效果有限。中医药主要通过调节机体阴阳平衡、增强免疫力等方式来治疗，但难以直接针对化疗的副作用进行精准干预。此外，中医药治疗需要一定的时间和过程，对于急需缓解化疗毒副作用引起的症状以及晚期癌症本身症状，其效果可能不够迅速和显著。
五、中晚期癌症患者的治疗选择建议
针对中晚期癌症患者的治疗选择，本文提出以下建议：
1. 综合考虑治疗方案：在制定治疗方案时，应综合考虑患者的身体状况、肿瘤类型、分期以及治疗方案的利弊等因素。避免盲目追求肿瘤杀灭效果而忽视患者的身体状况和生活质量。
2. 适度放化疗：对于需要放化疗的患者，应根据患者的具体情况制定适度的治疗方案。避免过度放化疗导致的身体损害，广泛转移和生活质量下降。
3. 重视个体化治疗：中晚期癌症患者的治疗应注重个体化治疗原则。根据患者的具体情况制定个性化的治疗方案，尤其针对已经广泛转移的晚期癌症患者，应避免过度放化疗，应该以提高患者的生活质量，延长寿命为目标客观选择中西医康复方案。
4. 加强中西医结合：在治疗过程中，应注重中西医结合的优势互补。中医药可以在缓解放化疗副作用、提高患者免疫力，减缓癌症进程，延长寿命等方面发挥积极作用；而西医则可以在生命支持、止痛、杀灭癌细胞、降低肿瘤标志物，控制肿瘤进展等方面提供支持。但是要准确评估中晚期癌症患者化疗的利弊，通过中西医结合的方式，为患者提供更全面、更安全、更有效的治疗服务。
结论
综上所述，中晚期癌症患者不建议过度放化疗的合理性在于避免加剧身体负担、降低生活质量，缩短患者寿命以及影响治疗效果等潜在危害。在制定治疗方案时，应综合考虑患者的具体情况和治疗方案的利弊等因素；注重个体化治疗原则；加强中西医结合的优势互补。以期在保障患者生活质量的基础上，实现更为合理的治疗选择。同时，本文也呼吁医学界和广大患者及家属关注中晚期癌症患者的治疗需求和身心健康问题，共同推动癌症治疗事业的进步和发展。
附：化疗是一种常见的抗肿瘤疗法，但也会带来一系列的副作用。以下是化疗可能产生的副作用，详细列出并归纳如下：
一、消化系统症状
恶心
呕吐
食欲减退
腹泻
便秘
腹胀
腹痛
胃胀
口腔溃疡
二、血液系统症状
白细胞减少
血小板减少
贫血
红细胞减少
三、免疫系统症状
易感染
发热
寒战
四、神经系统症状
手脚麻木
手脚疼痛
记忆力减退
神经毒性
五、其他系统症状
乏力
疲劳
脱发
色素沉着
皮疹
过敏反应
心脏毒性
肝脏毒性
肾脏毒性
耳毒性
听力下降
呼吸困难
咳嗽
咳痰
肌肉疼痛
关节疼痛
失眠
焦虑
抑郁
味觉改变
嗅觉改变
视力模糊
口干
口腔溃疡
出血倾向
血栓形成
电解质紊乱
营养不良
体重下降
骨质疏松
免疫力下降
甲状腺功能异常
肾功能受损
肝功能受损
心肌损伤
手足综合征
肺纤维化
心律失常
心衰
血尿
肾功能问题
指甲改变
皮肤干燥
剥脱性皮炎
全身皮肤红斑
末梢神经毒性
肢端麻木
肢端感觉迟钝
手足甲沟炎
指甲改变
作者简介：梁世杰 中医高年资主治医师，从事中医临床工作24年，积累了较丰富的临床经验。师从首都医科大学附属北京中医院肝病科主任医师、著名老中医陈勇，侍诊多载，深得器重，尽得真传！擅用“商汤经方分类疗法”、专病专方结合“焦树德学术思想”“关幼波十纲辨证”学术思想治疗疑难杂症为特色。现任北京厚德为怀医生集团渐冻症研究中心主任，北京树德堂中医研究院研究员，北京中医药薪火传承新3+3工程—焦树德门人（陈勇）传承工作站研究员，国际易联易学与养生专委会常务理事，中国中医药研究促进会焦树德学术传承专业委员会委员，中国药文化研究会中医药慢病防治分会首批癌症领域入库专家。荣获2020年中国中医药研究促进会仲景医学分会举办的第八届医圣仲景南阳论坛“经方名医”荣誉称号。2023年首届京津冀“扁鹊杯”燕赵医学研究主题征文优秀奖获得者。
A rationale analysis of not recommending excessive chemoradiotherapy in patients with Advanced and advanced cancer
abstract
The purpose of this article is to explore the potential harm of overdose radiotherapy and chemotherapy, combined with the extensive side effects of chemotherapy. Based on the detailed summary of side effects of chemotherapy, this paper proposes that for advanced cancer patients, over-reliance on radiotherapy and chemotherapy may not significantly improve the treatment effect, but may aggravate the burden of patients and reduce the quality of life. Traditional Chinese medicine treatment can alleviate some side effects, but in the face of continuous chemotherapy brings huge complex health issues, its effect is limited. Therefore, this paper recommends that patients with advanced stage cancer should consider the pros and cons of treatment options in a comprehensive manner and avoid excessive chemoradiotherapy, in order to achieve more reasonable treatment options on the basis of ensuring the quality of life of patients.
keyword
Advanced cancer, Radiotherapy and chemotherapy, Side effect, Quality of life, Traditional Chinese Medicine
Introduction
As one of the major diseases threatening human health, the choice of treatment methods has always been the focus of the medical community. For early stage cancer patients, surgery is often the preferred treatment, while for middle and advanced patients, chemoradiotherapy and targeted therapy are important treatments. However, with the progress of treatment, the side effects of radiotherapy and chemotherapy gradually appear, especially for the advanced cases. From the side effect of chemotherapy, this article discusses the reasonableness of not recommending too much radiotherapy and chemotherapy.
text
I. Current status and challenges in the treatment of advanced and advanced cancer
The treatment challenge for patients with advanced-stage cancer is that the tumor has already metastasized locally or distantly, and surgery alone is difficult to completely cure. Therefore, radiotherapy and targeted therapy have become important complementary treatments. However, while these treatments kill cancer, they also cause damage to normal cells, causing a series of side effects.
Extensive side effects of chemotherapy
As a common anticancer therapy, chemotherapy has extensive and complex side effects. According to Liang Shijie's research team, the side effects of chemotherapy include at least 50 items, covering digestive system, hematological system, immune system, nervous system and so on. Here is a breakdown of the side effects of chemotherapy:
1. Digestive symptoms: nausea, vomiting, loss of appetite, diarrhea, constipation, bloating, abdominal pain, bloating of the stomach, mouth sores, etc. These symptoms directly affect the patient's eating and nutrient absorption, leading to malnutrition and weight loss.
2. Haematological system symptom: White blood cell decreases, plaque decreases, anaemia, red blood cell decreases etc. These symptoms may increase a patient's risk of infection while affecting blood clotting function, leading to a tendency to bleed.
3. immune system symptoms: susceptible to infection, fever, chills, etc. Chemotherapy results in damage to the immune system, leaving the sufferer more vulnerable to causative agents.
4. Nervous system symptoms: numbness, pain in hands and feet, memory loss, neurotoxicity, etc. These symptoms may affect the patient's daily life and cognitive functioning.
5. Other systemic symptoms: fatigue, hair loss, pigmentation, rash, allergic reactions, etc. These symptoms not only affect the appearance and self-confidence of the patient, but they can also cause psychological problems. In addition, chemotherapy may also cause heart toxicity, liver toxicity and kidney toxicity to cause damage to the patient's internal organs.
III. The harm of excessive chemoradiotherapy to patients with advanced and advanced cancer
For patients with advanced-stage cancer, excessive chemoradiotherapy may cause the following harms:
1. Increased physical burden: Patients with advanced-stage cancer are in poorer physical condition themselves, and excessive chemotherapy may further increase the physical burdens, causing the patient's physical condition to worsen.
2. Reduced quality of life: Side effects of chemotherapy can seriously affect the daily life of the patient, such as nausea, vomiting, diarrhea and other symptoms may lead to normal eating; Symptoms such as fatigue and fatigue may affect the patient's ability to perform daily activities. These side effects not only reduce the quality of life, but also may cause psychological problems, such as anxiety, depression.
3. Impact on therapeutic outcomes: Excessive chemoradiotherapy may lead to a decrease in patient tolerance to treatment, which can affect the outcome of treatment. At the same time, while killing cancer cells, chemotherapy drugs also cause damage to normal cells, causing the body's immunity to decline and increasing the risk of infection.
Fourth, the limited nature of traditional Chinese medicine to alleviate the side effects of chemotherapy
Although traditional Chinese medicine (TCM) emphasizes the whole concept and individualized treatment, and TCM has some advantages in alleviating the side effects of radiotherapy and chemotherapy, its effect is limited in the face of the huge and complex health problems caused by chemotherapy. Traditional Chinese Medicine (TCM) mainly treats the disease by regulating the balance of yin and yang of the body and enhancing the immune system, but it is difficult to directly intervene the side effects of chemotherapy. In addition, TCM treatment takes a certain period of time and process, for the urgent need to alleviate the side effects of chemotherapy caused by the symptoms of advanced cancer itself, its effect may not be rapid and significant.
V. Suggestions for treatment options for patients with advanced and advanced cancer
With regard to treatment options for patients with advanced and advanced cancer, the following recommendations are made in this paper:
1. Consider a comprehensive treatment plan: When developing a treatment plan, consider factors such as the patient's physical condition, tumor type, stage, and the pros and cons of the treatment plan. Avoid blindly pursuing tumor-killing effects while ignoring the patient's physical condition and quality of life.
2. Moderate chemoradiotherapy: For patients who need chemoradiotherapy, a moderate treatment plan should be developed according to the specific conditions of the patient. Avoid the physical damage, widespread metastasis and reduced quality of life caused by excessive chemoradiotherapy.
3. Pay attention to personalized treatment: The treatment of patients with advanced stage cancer should focus on the principle of personalized treatment. Develop a personalized treatment plan according to the specific conditions of the patient, especially for advanced cancer patients who have already had extensive metastases, avoid excessive chemoradiotherapy, and objectively select Chinese and Western medical rehabilitation programmes with the goal of improving the quality of life and extending the life of the patient.
4. Strengthen the combination of Chinese and Western medicine: In the course of treatment, attention should be paid to the complementarity of the advantages of the combinations of Chinese and western medicine. Traditional Chinese medicine can play a positive role in alleviating side effects of radiotherapy and chemotherapy, improving immune system, slowing down cancer progress and prolonging life span. Western medicine can provide support for life support, pain relief, killing cancer cells, reducing tumor markers, and controlling tumor progression. However, it is necessary to accurately evaluate the pros and cons of chemotherapy for patients with advanced and advanced cancer, and provide patients with more comprehensive, safer and more effective treatment services through a combination of Chinese and Western medicine.
conclusion
In conclusion, the reasonableness of not recommending excessive chemoradiotherapy for patients with advanced stage cancer lies in avoiding potential harms such as exacerbating the body burden, reducing quality of life, shortening the patient's life, and affecting the effectiveness of treatment. When developing a treatment plan, consideration should be given to factors such as the specific situation of the patient and the advantages and disadvantages of the treatment plan; Focus on the principle of individualized treatment; Strengthen the complementarity of combinations of Chinese and Western medicine. In order to achieve more rational treatment options on the basis of ensuring the quality of life of patients. At the same time, this paper also calls on the medical profession and the general patient and family to pay attention to the treatment needs and physical and mental health issues of patients with advanced stage cancer, and jointly promote the progress and development of cancer treatment.
PS: Chemotherapy is a common anticancer therapy, but it also brings a series of side effects. The following are the possible side effects of chemotherapy, which are detailed and summarized as follows:
Symptoms of the digestive system
nausea
Vomit
Loss of appetite
diarrhea
constipation
Bloating
bellyache
Stomach bloated
Mouth ulcer
II. Blood System Symptoms
White blood cell decrease
Reduced platelets
anemia
Red blood cells are reduced
Three, the immune system symptoms
Vulnerable to infection
fever
shiver
Symptoms of the nervous system
My hands and feet are numb.
Pain in the hands and feet
Memory loss
Neurotoxicity
V. Other Systemic Symptoms
weak
fatigue
Hair loss
Hyperpigmentation
Rash
allergic reaction
Heart toxicity
Liver Toxicity
Kidney toxicity
Ear toxicity
Hearing loss
Dyspnea
cough
to cough up phlegm
Muscle Pain
Joint Pain
insomnia
anxious
depressed
Changes in taste
The sense of smell changed
Vision is blurry
Dry mouth
Mouth ulcer
Prone to bleeding
thrombosis
Electrolyte Disorder
malnutrition
Weight loss
osteoporosis
Immunity declines
Thyroid gland dysfunction
Damage to kidney function
Impaired liver function
Heart muscle injury
Hand and foot syndrome
Pulmonary fibrosis
arrhythmia
Heart failure
hematuria
Kidney function problems
The nails changed
The skin is dry
Epithelial dermatitis
Red patches on the skin throughout the body
Terminal nerve toxicity
Numbness in the limbs
Feeling sluggish in the extremities
Nail gingivitis on the hands and feet
Author Bio: Liang Shijie is a senior medical practitioner in traditional Chinese medicine. He has been engaged in traditional medicine clinical work for 24 years and has accumulated a wealth of clinical experience. Following Chen Yong, chief physician of liver disease at Beijing Traditional Medicine Hospital, affiliated with Capital Medical University, and renowned old Chinese medicine, he has been treated for many years and received great attention. He specializes in the treatment of difficult diseases using "conversational traditional therapy" and special treatments combined with the academic ideas of Jiao Shude and Guan Yubo's ten-level diagnosis.He is currently the director of the Center for Diffusion Research of Dr. Houde Wei Group in Beijing, a researcher at the Shude Tang Institute of Chinese Medicine, and a fellow at the new 3 + 3 project of traditional Chinese medicine flame inheritance in Beijing - a scholar at the inheritance work station of Jiao Shude's protégés (Chen Yong),He is a standing committee member of the International Expert Committee on E-learning and Health Care, a member of the Jiao Shude Academic Heritage Special Committee of the Chinese Association for the Advancement of Chinese Medicine Research, and the first cancer specialist to be included in the chapter of the Chinese Pharmaceutical Culture Research Association. Won the 2020 China Association for the Promotion of Traditional Chinese Medicine Zhongjing Medical Branch held the eighth session of the Medical Saint Zhongjing Nanyang Forum "Classic Prescription Famous Doctor" honorary title. The winner of the first Beijing-Tianjin-Hebei "Pingui Cup" Yanzhao Medical Research Essay Award in 2023.
来源：首都专家梁世杰
