Research on TCM

Research on TCM
Participants perceived that research was instrumental to
promote TCM recognition and its dissemination to Western
countries. TCM professionals admitted that the most
important barrier for the dissemination of TCM was the
absence of clinical research evidence. Therefore, they
showed a great interest in evaluating the effectiveness and
safety of TCM for cancer. At the same time, they stated
that they need support and training in clinical research
methodology. They believed that collaboration between
Western investigators and Chinese TCM clinicians would
help fulfil this need. Both patients and TCM practitioners
hoped that Western patients could have access to the
TCM benefits that they experienced.
DISCUSSION
We found that the cancer patients in this study decided to
use TCM as part of a self-help process that has a deep cultural
grounding, related to the traditional Chinese philosophy
of life. Participants perceived TCM to be an effective
and harmless therapy. They highly valued the fact that
TCM is tailored to patients, and believed that it was the
basis of an optimal and safe treatment. Participants also
highlighted the long-term positive effects, the benefits of
group interventions, and the low cost as important features
of TCM in cancer care. Subjects believed that future
clinical research is crucial for the recognition and dissemination
of TCM in Western countries.
One limitation of this qualitative study is that the
results were based on a sample of patients who were
selected by their TCM physicians. Patients who were ‘success
stories’, who had good relationships with their doctors
and who were in better health were more likely to
attend the focus groups. Therefore, it is not surprising that
there was a strong support for TCM along with descriptions
of positive experiences. However, we believe that
the perspectives emerged from these discussions were
quite representative of the general opinion of TCM in
China. The main reason for this is that these perspectives
(hence the use of TCM) are strongly related to a Chinese
philosophy of life that is deeply engrained and rooted
within the entire Chinese population. This cultural factor
is a very important source of expectations and beliefs in
TCM benefit, and hence positive experiences with TCM.
Strong beliefs and expectations of a therapy are
certainly important components that lead to positive
experiences in treatment effect. However, we cannot differentiate
between socio-cultural factors and biological
effects in a qualitative study or a simple observational
study. As the use of TCM in Western countries is not
related to such socio-cultural contexts, the effects
observed in these countries may be different from those
reported in China.
For these Chinese patients, the belief in TCM philosophy
and paradigm was sufficient for them to decide on its
use. The TCM professionals provided case material and
clinical observations as proof of their claims and this evidence
was well accepted by patients. Such anecdotal evidence,
however, is certainly not sufficient to convince
Western authorities and patients to use TCM. Therefore,
positive results from strict clinical trials would be necessary
to convince Western health professionals to adopt
TCM in their practice.
This study was the first step in developing a collaborative
programme between Canada and China to formally
evaluate the effectiveness and safety of TCM in
cancer care. This study was conducted in China because
we wanted to explore the long-standing traditional use
of these treatments. The results will contribute to the

knowledge base regarding current models of TCM cancer
care in China, as well as providing useful information
to help develop future clinical trials in Western
countries. There have been a few randomized controlled
trials (RCTs) conducted in China that aimed to evaluate
the efficacy of TCM therapies (Wong
et al
. 2001). However,
new studies, with more stringent methodology, are
required. A pilot RCT, supported by the Canadian Institutes
of Health Research, is being conducted in Canada
to assess the feasibility of conducting full-scale RCTs. In
that study we will assess personal beliefs and expectations
regarding TCM prior to administering the interventions.
We will then determine the association
between these socio-cultural factors and the efficacy of
TCM. The qualitative study reported in this paper
underscores the paramount importance of comparing
medical practices in different countries, in order to identify
the role of cultural beliefs in the effectiveness of
interventions.