TCM as Adjunctive Support During Chemotherapy for Nasopharyngeal Carcinoma: A Case Report

Kit Li

Case sharing

Mr M        49 y/o

A male patient was diagnosed with Stage II nasopharyngeal carcinoma in the summer of 2019. His first noticeable symptom was the appearance of a lump on the right side of his neck, which was subsequently identified as an enlarged cervical lymph node associated with the malignancy. The primary tumour was located in the nasopharynx, behind the nasal cavity at the base of the skull.

Prior to his diagnosis, the patient maintained a healthy and active lifestyle. He exercised regularly, participating in outdoor bootcamp classes and practising Pilates. He had never smoked and consumed alcohol only occasionally and in small amounts.

Over the past year, the patient underwent approximately 19 cycles of chemotherapy. Although the treatment was necessary, it resulted in significant adverse effects that severely compromised his overall health and quality of life. One of the most debilitating complications was right-sided Bell's palsy, leaving him unable to fully close his right eye or the right side of his mouth, particularly during sleep. He also experienced substantial unintentional weight loss, marked physical weakness and fatigue, and bilateral hearing impairment. In addition, following one of his surgical procedures, he developed a perforation of the right tympanic membrane (eardrum), which further contributed to his hearing difficulties.

Seeking complementary therapy to alleviate the significant adverse effects of his cancer treatment, the patient was referred to Dr Tang by a friend. He first attended the clinic in November 2025 with the primary aim of improving his treatment-related symptoms and overall quality of life. Since then, he has received weekly acupuncture treatments under Dr Tang's care, together with individually prescribed Chinese herbal decoctions tailored to his clinical presentation. This integrative treatment approach was intended to complement his conventional oncology care by alleviating treatment-related side effects, supporting his recovery, and enhancing his overall physical well-being.

Encouragingly, after receiving regular TCM treatment for several months, the patient's blood test results demonstrated improvements in his  haematological parameters. Although his blood cell counts remained below the normal reference ranges, they showed a gradual upward trend while he was receiving the prescribed Chinese herbal decoctions, suggesting a potential role in supporting haematological recovery during his chemotherapy treatment.

His blood test on 6 May showed:

• Haemoglobin: 111 g/L (Reference range: 130–170 g/L)
• Red Blood Cell Count: 3.6 × 10¹²/L (Reference range: 4.5–5.5 × 10¹²/L)
• White Blood Cell Count: 5.9 × 10⁹/L (Reference range: 4.0–10.0 × 10⁹/L)

Following a subsequent cycle of chemotherapy, his blood test on 20 May showed the expected treatment-related decline:

• Haemoglobin: 99 g/L
• Red Blood Cell Count: 3.3 × 10¹²/L
• White Blood Cell Count: 2.7 × 10⁹/L

With the continuation of weekly acupuncture and individually prescribed Chinese herbal decoctions alongside his conventional oncology treatment, his subsequent blood tests in June showed recovery of these haematological parameters toward acceptable levels.

His neurological recovery was equally encouraging. After an intensive course of acupuncture, his Bell's palsy improved dramatically. He regained normal facial movement, and his right eye was once again able to close naturally. Although there remained a very slight gap during forceful eye closure, his facial function had largely returned to normal.

Every cancer patient's journey is unique, and integrative medicine should never be regarded as a substitute for conventional oncology treatment. However, when used alongside standard medical care, acupuncture (1) and Chinese herbal medicine (2, 3)  may serve as valuable supportive therapies by helping to alleviate treatment-related adverse effects, improve quality of life, and facilitate recovery during the demanding course of cancer treatment.

This case represents a single clinical observation and therefore cannot establish a causal relationship between the interventions and the clinical outcomes. Nevertheless, the patient's improvements provide an encouraging example of the potential benefits of an integrative approach in supporting individuals experiencing chemotherapy-related adverse effects, including haematological suppression and neurological complications.

Importantly, these clinical observations are broadly consistent with the growing body of evidence supporting integrative oncology. Systematic reviews and international clinical guidelines suggest that acupuncture may help alleviate chemotherapy-related symptoms, including fatigue, nausea, peripheral neuropathy, xerostomia, and reduced quality of life. Emerging evidence also indicates that acupuncture, together with appropriately prescribed Chinese herbal medicine, may support recovery from chemotherapy-induced myelosuppression by promoting haematological recovery and improving tolerance to ongoing treatment. Furthermore, experimental studies have demonstrated that acupuncture can modulate inflammatory pathways, regulate autonomic nervous system activity, and enhance neuroplasticity, providing plausible biological mechanisms for the neurological recovery observed in this patient.

Although larger, well-designed randomised controlled trials are still needed to establish efficacy and clarify the underlying mechanisms, this case adds to the growing clinical experience suggesting that evidence-informed integrative medicine may offer meaningful supportive care for patients undergoing cancer treatment.

References:

1) Efficacy and Safety of Acupuncture Therapy for Leukopenia after Chemotherapy or Radiotherapy: A Systematic Review and Meta-analysis, European Journal of Integrative Medicine (2024): https://www.sciencedirect.com/science/article/pii/S187638202400043X

2) Chinese Medicine Combined with Adjuvant Chemotherapy for Improving Myelosuppression in Colorectal Cancer Patients: A Systematic Review and Network Meta-analysis: https://pubmed.ncbi.nlm.nih.gov/38212495/

3) Validated Herbal Extracts for Alleviating Chemotherapy-induced Myelosuppression: A Systematic Review and Meta-analysis: https://www.sciencedirect.com/science/article/abs/pii/S0944711325002995

Clinical Placement Reflection: Bell’s Palsy and TCM Perspective

Kit Li

During my first day of clinical placement, I shadowed Prof Yang Lu at the Acupuncture Department of Nanfang Hospital (1). His specialised areas include bloodletting therapy, auricular acupuncture, and embedding needle therapy for the treatment of neck, shoulder, lower back, and leg pain, Bell’s palsy, stroke rehabilitation, neurological disorders, and internal conditions such as asthma, vertigo, stomach pain, constipation, and obesity. Although the time was limited, the knowledge I gained from him was extremely valuable.

The Acupuncture Clinic was always fully packed and busy. I remember one morning when around 20 patients were queuing outside the treatment room waiting to be seen. The room contained 10 treatment beds, six electroacupuncture devices, TDP lamps, and three fully equipped trolleys containing various TCM tools. It was a simple medical setting, yet it consistently delivered effective care, as each professor had unique techniques and approaches to treating patients efficiently and successfully.

During my clinical practice, I encountered a wide range of conditions, including Cervical Spondylosis, Sciatica, Bell’s Palsy (BP), post-stroke symptoms, Parkinson’s Disease, cataracts, and emotional disorders. However, the most unforgettable case was a four year-old girl suffering from Bell’s Palsy. She was not the only patient with this condition; even among the adults, around six out of fifteen patients that morning were receiving treatment for Bell’s Palsy.

Honestly, I had never imagined that Bell’s Palsy could occur at such a young age. During the case discussion, Professor Yang explained that in younger patients, the condition is often associated with flu-like infections affecting the ear region.

From a TCM perspective, Bell’s Palsy is often categorised under 'Wind-Stroke' or 'Deviation of the Mouth and Eye'. When it appears after a viral illness, such as herpes simplex, shingles/Ramsay Hunt syndrome, flu-like infections, or an immune flare-up, TCM does not describe the virus in biomedical terms. Instead, it interprets the condition as an external pathogenic factor disrupting the body’s internal balance.

How Does TCM View Virus-Associated Bell’s Palsy?

1. Wind-Heat Toxin

Signs and symptoms: Cold or flu symptoms, sore throat, fever, swollen glands, ear pain, and facial inflammation.

Treatment principle: Expel Wind, clear Heat, resolve toxicity, and open the channels.

TCM interpretation: External Wind combined with Heat or Toxic Heat invades the channels, causing inflammation and obstructing the flow of Qi and Blood within the facial meridians.

2. Damp-Heat or Toxic Heat

Signs and symptoms: Heaviness, swelling, redness, ear vesicles (such as shingles), yellow phlegm, and digestive sluggishness.

Treatment principle: Clear Damp-Heat, detoxify, and transform Phlegm.

TCM interpretation: Dampness and Heat combine with toxin, obstructing circulation within the channels and collaterals.

3. Zheng-Qi Deficiency

Signs and symptoms: Stress, exhaustion, poor sleep, and overwork.

Treatment principle: Strengthen Wei-Qi (defensive Qi), support Spleen and Lung function, and prevent recurrence.

TCM interpretation: Wei-Qi becomes weakened, leaving the body more vulnerable to external pathogenic invasion.

4. Blood Deficiency with Channel Malnourishment

Signs and symptoms: Fatigue, pale complexion, dizziness, dry skin, numbness, muscle weakness, poor circulation, pale tongue, and thready pulse.

Treatment principle: Nourish Blood, regulate Qi and Blood circulation, and nourish the channels and sinews.

TCM interpretation:
When Blood is deficient, the channels and facial muscles become undernourished, weakening the body’s ability to support normal movement and tissue recovery. As a result, residual pathogenic factors may remain within the meridians, delaying healing and prolonging facial weakness or stiffness.

Once the patient’s condition has stabilised, acupuncture treatment (2, 3) should be considered as early as possible. The first seven days are especially crucial for recovery. Shallow needling is generally preferred, particularly on the affected side of the face. Daily treatment is considered ideal, although treatment three to four times per week may still be effective.

However, electroacupuncture is usually avoided during the first seven days, as the facial nerves are already inflamed and damaged, and excessive stimulation is not recommended during the acute stage.

I spoke with the little girl’s mother to better understand the onset of her condition. The child had suffered from a fever for three days in April, and on the fourth day, the left side of her face became paralysed. She was unable to blink her left eye, and the muscles around her mouth became difficult to control.

The recovery process may take approximately 20 days if daily treatment is provided, although outcomes vary depending on the patient’s condition and constitution. During my placement, I witnessed encouraging improvement by her sixth treatment on the fifteenth day. The facial muscles on the affected side had become more relaxed, especially around her left eye and mouth, which were beginning to move more naturally.

According to her mother, the only remaining noticeable issue was that her mouth would still deviate slightly when smiling or crying. She had initially started treatment twice a week from the end of April until mid-May.

On my last day of placement, I saw the little girl again. She was noticeably more cheerful, talkative, and relaxed than when I first met her at the Acupuncture Department.

Seven Key Lifestyle Suggestions for Patients

1. Consume more vegetables and fibre-rich foods in your diet, including tofu, bean products, sweetcorn, lean meat, onions, seaweed, red dates, hawthorn (Shanzha), bitter melon, winter melon, bananas, aubergines, pumpkins, and blackberries.
2. Avoid spicy and overly sour foods, hot-natured foods, strong tea, alcoholic drinks, lamb, and animal organs such as liver and kidneys.
3. Soak your feet in warm water before bedtime for 10–20 minutes to promote circulation and relaxation.
4. Minimise overstimulation from activities such as excessive phone use, television, and laptop screen time.
5. Moderate exercise is beneficial for recovery. Listening to calming music, maintaining a regular sleeping pattern, and keeping emotions stable may also support healing.
6. Perform gentle facial muscle exercises regularly, such as raising the eyebrows, tightly closing the eyes, puffing the cheeks, opening the mouth, wrinkling the nose, and smiling gently. Applying a warm damp towel to the neck and facial area may help relax the muscles. Avoid washing the face with icy cold water, as cold stimulation may aggravate the condition. During windy or cold weather, keep the face and neck well protected.
7. When facial muscles feel weak or difficult to control, practise gently closing the eyes and mouth tightly to improve muscle coordination and awareness.

This placement experience deepened my understanding not only of Bell’s Palsy from both biomedical and TCM perspectives, but also of the importance of early intervention, patient reassurance, and consistent treatment. Most importantly, it reminded me that healing is not only about restoring physical movement, but also about rebuilding confidence, comfort, and hope in the patient’s daily life.

References: 

1) Nanfang Hospital: https://www.smu.edu.cn/english/info/1026/1068.htm

2) Cochrane Review: 'Acupuncture for Bell’s Palsy': 

https://www.cochrane.org/evidence/CD002914_acupuncture-bells-palsy

3) Compare the efficacy of acupuncture with drugs in the treatment of Bell's palsy: A systematic review and meta-analysis of RCTs: https://pubmed.ncbi.nlm.nih.gov/31083225/

Sudden Temperature Drop Triggering Neck Pain, Dizziness, and Wind-Stroke: A TCM Perspective

Kit Li

  

I remembered one Friday morning during my clinical placement at the A&E department of the Integrated Hospital of Traditional Chinese and Western Medicine, Southern Medical University ⁽¹⁾, the waiting area was crowded and busy. Approximately two-fifths of the patients presented with Neck Pain,  Dizziness, or Minor Stroke  ⁽²⁾. This surge in cases followed an overnight temperature drop in Guangzhou, from 29c to 20c.

Many of these patients had a history of Hypertension or previous Stroke, and some also suffered from underlying chronic health conditions. They exhibited symptoms such as Bell's Palsy  ⁽³⁾, deviation of the mouth and eyes, numbness, stiff neck, dizziness, and tinnitus (4) . According to TCM theory, these manifestations arise from Internal Wind , which develops due to disharmony within the body.

Pathogenesis in TCM

In TCM, there are six types of external pathogenic factors, which knowns as the Six Evils: Wind, Cold, Summer Heat, Dampness, Dryness, and Fire. Among these, Wind is considered the primary and leading pathogenic factor.

When external Wind invades the body, it obstructs the meridians, leading to neck stiffness. As the obstruction deepens, Qi and Blood circulation become impaired, resulting in dizziness. Prolonged stagnation may generate Internal Wind, and if left untreated, this can culminate in Wind-Stroke.

Characteristics of Wind Evil

Wind is Yang in nature, mobile, changeable, and rising upward. It is also known as 'The Leader of a Hundred Diseases'.

Typical characteristics include: 

1. Sudden onset and rapid change
2. Migrating symptoms (pain or numbness that moves from place to place)
3. Tendency to affect the upper part of the body and the superficial layer of the skin.

Common disorders associated with Wind:

1. Common cold, allergies, dizziness, tremors, Wind-Stroke (Internal Wind)
2. Skin conditions such as itching or hives

Wind's tendency: It easily combines with other pathogenic factors, forming patterns like Wind-Cold or Wind-Heat.

Internal Wind Mechanism

Internal Wind tends to attack the upper body, especially the head and neck, obstructing the meridians and disturbing the clear orifices (the brain, eyes and ears). In severe cases, when Yin and Yang collapse, symptoms such as loss of consciousness and paralysis occur, typical of Wind-Stroke.

Common internal causes include:

1. Liver Yang Rising or Liver Wind stirring due to Yin-deficiency
2. Phlegm-Fire obstructing the channels
3. Qi and Blood-deficiency, allowing Wind to invade the meridians

Neck Pain

In TCM, neck pain arises from Qi and Blood stagnation in the meridians, especially those of the Taiyang channels (Bladder and Small Intestine), and sometimes the Shaoyang channels (Gallbladder and Sanjiao).

Possible causes include:

1. External invasion of Wind-Cold or Wind-Damp, which blocks the flow of Qi, leading to stiffness and restricted movement.
2. Internal causes, such as Liver Qi-stagnation, Blood Stasis, or Kidney-deficiency (often seen in chronic cases with weak bones or tendons).
3. Emotional tension or stress, which constrains Liver Qi and affects the Gallbladder and Shaoyang channels running along the sides of the neck.

Dizziness

In TCM, dizziness isn't viewed as just a symptom of the inner ear or blood pressure, but rather as a manifestation of internal imbalance, particularly involving the Liver, Spleen, Kidney and the movement of Qi, Blood and Body Fluids. It occurs when “Clear Yang not ascending, Turbid Yin not descending”. The main underlying causes include:

1. Liver Yang-Rising or Liver-Wind stirring (most common)
2. Phlegm-Damp obstructing the clear orifices of the head
3. Qi and Blood Deficiency, failing to nourish the brain
4. Kidney Essence-Deficiency, leaving the marrow and brain undernourished

Interconnection between Wind-Stroke, Neck Pain and Dizziness

These three conditions are closely interconnected. Neck pain and dizziness can be viewed as early warning signs of Internal Wind formation. When similar pathological patterns, such as Liver Yang Rising, Phlegm Obstruction, or Qi Stagnation, intensify or suddenly flare up, they may progress to Wind-Stroke.

Shared mechanisms include:

1. Liver involvement: The Liver governs Wind and regulates of Qi flow. When Liver Qi stagnates or Liver Yang rises, internal Wind develops, manifesting as neck stiffness, dizziness, tremors, or stroke-like symptoms.
2. Wind pathogen progression: External Wind first invades the Taiyang or Shaoyang channels of the head and neck. If not expelled, it can transform into Internal Wind, initially causing neck pain, then dizziness, and in severe cases, Wind-Stroke.
3. Qi, Blood, and Phlegm obstruction: When channels in the head and neck are blocked, Qi movement becomes impaired, leading to dizziness, headache, stiffness, and sometimes facial deviation or paralysis.
4. Yang Rising and Yin-deficiency: With again, stress, or chronic imbalance, Yin fails to anchor Yang, resulting in Liver Yang Rising and Wind stirring. This may manifest as dizziness, hypertension, and an increased risk of Wind-Stroke.

Summary

1. Neck pain often indicates meridian blockage, particularly in the Taiyang or Shaoyang channels.
2. Dizziness reflects an imbalance between clear Yang and turbid Yin, often related to Liver or Phlegm disturbances.
3. Wind-Stroke represents the acute and severe stage of these pathological developments, when Internal Wind suddenly rises to disturb the brain and channels.

Treatment Approach

1. Scalp acupuncture combined with electro-acupuncture (5) , applied to key functional areas such as the Sensory Area, Head Area and Chorea-Tremor Area..etc, along with selected points on the Du or Ren meridians, using the Dao-qi technique.
2. During the first two sessions, body acupoints on the Hand and Foot Yangming meridians are applied to the stronger side of the body to enhance Qi and Blood circulation, promoting recovery of the affected side. Needles are retained for 30 minutes, followed by stimulation of Shu-points on specific Yin meridians, following Professor Zhou's Twelve Meridian Method (6).
3. Moxibustion is applied on the affected side to warm the meridians and promote the flow of Qi and Blood.
4. Chinese herbal prescriptions should be tailored to the patient's individual constitution and pattern differentiation. Professional consultation with a qualified TCM practitioner is essential for accurate diagnosis and safe, effective treatment.

This clinical experience deepened my understanding of how sudden climatic changes can provoke Internal Wind and related disorders. It also reinforced the importance of early intervention and the integrative power of TCM in restoring balance and preventing more serious outcomes like Wind-Stroke.

References: 

1) Integrated Hospital of Traditional Chinese and Western Medicine of Southern Medical University: https://www.nfzxy.com/

2) Minor Stroke

https://pmc.ncbi.nlm.nih.gov/articles/PMC9616153/

3) Bell's Palsy

https://www.mdpi.com/2813-7914/1/3/24

4) Tinnitus

https://pubmed.ncbi.nlm.nih.gov/39331935/

5) Early intervention with electrical stimulation reduces neural damage after stroke in non-human primates: https://www.nature.com/articles/s41467-025-61948-y

6) Professor Zhou Guoping, Chief Physician, Professor, Medical Doctor, Doctoral Supervisor, serves as the Director of the Acupuncture, Moxibustion, and Rehabilitation Department at the Integrated Traditional Chinese and Western Medicine Hospital of Southern Medical University. He is recognized as a "Lingnan Acupuncture Master" and a "Renowned Doctor of Yangcheng."