Henry McGrath has undertaken an ambitious challenge in producing a book that outlines the theory and application of Chinese medicine in the treatment of cancer. He has met the task with insight, building on the foundation of his experience in this area of practice, both in the UK and China. Written and presented in six chapters, Harmony in the Face of the Tiger leads the reader through an exploration of the Chinese understanding and approach to cancer by looking at some of the diagnostic terms and how they fit into the framework of Oriental medicine. He introduces some of the philosophical roots from which Chinese medicine has evolved over the centuries, and goes on to address the treatment of cancer with acupuncture and moxibustion, herbal medicine, diet, qigong and feng shui.
It was difficult to discern for whom this book is intended: a student of Chinese medicine, the practitioner with a particular interest in working with patients with cancer or the person diagnosed with cancer about to begin their potentially distressing journey? It is certainly a useful resource for students who are discovering the qualities and dynamics of qi, yin and yang and the diagnostic concepts of ba gang and wu xing. For the practitioner it sheds light on research in this field and offers plenty of strands of knowledge to pursue with further reading. I couldn’t help thinking, however, that for the average patient it might delve a little too deeply into Chinese medical theory. The concepts of qi in its various forms - stagnation, blood stasis and phlegm - are challenging to grasp. It might have been more accessible and engaging for lay readers if more diagrams, illustrations, bold type and underlining were included when defining Chinese concepts and terminology. For example, tabular formatting is used with great effect in Chapter 5, ‘Nourishing the Soul’, where the author highlights the energetic qualities of food.
There were a few areas that struck me as misleading and requiring more explanation. The first appears in the introduction, and was written with reference to the treatment of cancer with Western medicine: ‘By concentrating solely on the disease, it tends to miss the human being involved. It does not attempt to sustain people through the harrowing process of diagnosis, treatment and recovery. It does not equip people to face the challenging issues that cancer diagnosis brings…’ Although this is undoubtedly the case with many aspects of conventional Western medical care, it is by no means the whole story. I have personally sat in multi-disciplinary team meetings as a representative for complementary therapies - alongside consultants in palliative medicine, clinical nurse specialists, social workers, bereavement counsellors, physiotherapists, priests and occupational therapists - and been moved by the attention, respect and concern shown towards the physical, emotional and spiritual welfare of the patients under review (as well as their families and close friends). In the quotation above the author also makes the assumption that recovery necessarily follows diagnosis and treatment; there is little reference in this book to death or end-of-life care.
This book does not suggest in any way that acupuncture and Chinese medicine can cure cancer. When we suggest that a particular point can resolve phlegm or move stagnation to treat cancer, however, we must tread carefully to avoid giving false hope or misleading our patients. This is a delicate area and it seems to me that McGrath is at times in danger of being over-optimistic in his claims for TCM – phlegm, after all, can be a stubborn pathogen to resolve. He uses the word ‘cancer’ very loosely throughout the book; cancer is a diagnosis that describes a broad range of clinical pictures - from a recent positive test of a breast lump biopsy to the painful ascites and oedema experienced by a patient with end-stage ovarian cancer. It is always clinically important to differentiate the type and stage of the disease and develop appropriate treatments specific to the individual patient and their condition.
On occasion, McGrath has a tendency to make statements that are too sweeping and generalised to be useful. For example he writes (p.146) that, ‘the emphasis is placed on tonifying, rather than on clearing, in patients with cancer. Herbs are therefore selected which have a gentle nature.’ If as practitioners we have a clear sense of diagnosis and treatment principles it can be entirely appropriate to use clearing and moving herbs with some patients, whereas with others it is not appropriate - what is important is being able to correctly distinguish between the two.
McGrath shows throughout this book that Chinese medicine has a huge role to play alongside conventional medicine in supporting patients with life-threatening illness - through diagnosis, treatment and assisting recovery as well as influencing the quality of a patient’s life as they face death. I am nervous about this book being picked up by patients who could be left confused; at the same time, I fear that practitioners might find some aspects too simplistic. Its main value, I suspect, is as an introduction to the subject for students interested in this area and, as such, it offers a rich insight into the complex world of Chinese medicine and how it approaches the treatment of cancer. Despite reservations, McGrath has produced a valuable book and my hope – as I suspect is his – is that it may inspire and encourage students to work with patients experiencing cancer and other life-threatening diseases.