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

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.