https://blog.naver.com/ham1sh/224281660681
The patient we will discuss today was a man with Stage IV prostate cancer. While organizing old medical records from the past, I have not yet been able to locate all of his previous charts, so this lecture is based mainly on materials prepared for outside presentations. Therefore, detailed laboratory data such as precise PSA values are unfortunately missing.
The reason I have begun organizing these older cases retrospectively is because cancer treatment in Korean medicine has often shown remarkable effectiveness. In some situations, even when conventional Western medicine considered treatment impossible and gave up hope, unexpected recoveries and near-miraculous outcomes were achieved. However, many of these valuable cases were forgotten over time and remained largely unknown to the public.
For that reason, I decided to revisit and systematically organize these meaningful historical cases one by one, so that future generations of practitioners may study them and perhaps discover new directions for treatment. If time permits, I hope to recover more detailed records from the past and supplement these cases further. For now, however, I ask for your understanding that I am presenting these cases based on the materials currently available in my possession.
The patient discussed today had Stage IV prostate cancer. At that time, surgeons at Inje University Paik Hospital attempted an operation and performed an exploratory laparotomy. However, once the abdomen was opened, they found that the cancer had already spread extensively throughout multiple areas. The disease was considered inoperable, and the surgeons closed the abdomen without proceeding further.
Afterward, the patient came to me and received only herbal treatment based on Korean medicine, without any conventional anticancer therapy. This was in 2001, approximately 25 years ago. At that time, my understanding of Western oncology was still in its early stages, and I had only begun studying and classifying pharmaceutical anticancer agents according to constitutional typology. Therefore, in this particular case, no Western medication was applied, and the patient was treated solely with herbal medicine.
There was also extensive bladder invasion along with bone metastasis. The tumor had additionally invaded the rectum, causing severe narrowing of the bowel lumen, so that the stool could pass only in an extremely thin form, even narrower than the thickness of a little finger.
A mass measuring approximately 9.1 × 4.4 cm had invaded the bladder wall and also extended into the rectum, compressing the rectal lumen so severely that the opening was barely visible.
The patient underwent an attempted operation at Inje University Paik Hospital. However, after opening the abdomen, the surgeons found that the cancer had already metastasized extensively to multiple sites. Because the disease was considered far too advanced for surgical treatment, the operation was abandoned and the abdomen was immediately closed.
The patient was subsequently informed that he had an estimated life expectancy of only about two months.
After conventional Western medicine had given up on further treatment, the patient came to Banryonginsu Korean Medicine Clinic, where he was treated with herbal medicine alone using the B0054 multi-herbal formulation.
He was also instructed to completely stop the alcohol and smoking habits he had previously enjoyed and to follow a very strict dietary regimen.
In many cases, patients who receive a terminal diagnosis actually respond better to treatment. One reason is that conventional Western medicine has already given up on them, and after hearing such pessimistic prognoses, patients often feel that they have no remaining option except to devote themselves fully to Korean medicine treatment.
However, patients react quite differently when they are told by Western physicians that there is still “some possibility” of treatment. What physicians often mean is the possibility of prolonging survival, but many patients interpret those words as meaning complete cure.
Patients who have previous experience with cancer, or who have witnessed family members go through cancer treatment, tend to understand the reality more deeply. In modern times, because medical insurance coverage has become extensive, many patients stay in long-term care hospitals and frequently witness other cancer patients returning with recurrence or progression. As a result, they may feel uneasy about relying exclusively on conventional treatment alone.
On the other hand, people who have never personally encountered cancer often place absolute trust in Western medicine. They may believe that herbal medicine should never be taken, and regarding diet, they are often told that “a cancer patient must eat well in order to endure chemotherapy.” Consequently, some begin consuming large amounts of meat and high-calorie foods without restraint. In my view, this can be extremely dangerous.
In Western countries, especially in the United States, when a physician gives a prognosis, patients and families often trust it almost completely. If a doctor says, “You may have one year left,” many patients accept it as a realistic expectation. They begin organizing their lives, spending time with family, traveling, and preparing emotionally for the remainder of their lives. In many cases, the clinical outcome ends up being relatively close to the original prognosis.
Korea, however, has a very different medical and cultural atmosphere.
One major difference is that Korean cancer patients often pursue extensive lifestyle changes and complementary approaches in addition to standard medical treatment. Many patients adopt plant-based or restrictive diets, begin exercising regularly, practice barefoot walking, improve sleep habits, reduce stress, and actively search for integrative or traditional therapies. Korean media frequently introduces stories of patients who reportedly exceeded expectations through lifestyle modification and personal effort, and many books and television programs reinforce the idea that prognosis is not necessarily fixed.
As a result, Korean patients and families are often less likely to accept a prognosis passively. Instead, they tend to continue searching for additional possibilities beyond standard treatment alone. In this sense, one could say that standard oncology treatment represents the “regular curriculum,” while lifestyle intervention, exercise, nutrition, and complementary therapies function as a form of “extra study” beyond the standard course.
Of course, this does not mean that all alternative approaches are scientifically proven, nor does it mean that standard medicine should be rejected. Cancer biology is extremely complex and involves genetics, immunity, metabolism, inflammation, hormones, and environmental factors. However, lifestyle changes such as exercise, nutritional improvement, stress reduction, and strong family support can meaningfully influence physical condition, quality of life, and sometimes even long-term outcomes in certain patients.
Patients who rely exclusively on conventional treatment without actively participating in lifestyle management may not achieve the same results as those who combine standard care with broader supportive efforts. Therefore, the most realistic and effective approach may not be to oppose conventional medicine and complementary care, but rather to integrate them in a balanced and evidence-conscious manner.
This CT scan demonstrates the treatment outcome of the herbal monotherapy using the B0054 multi-herbal formulation administered over a 9-month period, from July 2001 to April 2002. The previously visible rectal tumor appears to have almost completely regressed, with near disappearance of the lesion observed on follow-up imaging.
2001.07.30 (Initial CT) : A significant mass is seen on the right side along the ischial wall.
Size: 9.87 × 4.4 cm
2002.01.29 (6 Months Later) : The size of the lymph node along the left pelvic wall decreased from 4.4 cm to 1.5 cm.
2002.04.19 (9 Months Later) : The lesion has further decreased and remains stable in a similar appearance.
2001.07.30 (Initial CT) : The posterior wall of the urinary bladder is irregularly thickened, and a mass is seen extending into the rectum
Enhanced scan (Delayed phase): On the coronal reformat image, the mass originates from the cervix, directly invades the urinary bladder, and extends to the rectum.
The rectum is compressed to the left side. (Enhanced scan)
2002.01.29 (6 Months Later) : Previously seen central mass of the uterus has markedly decreased in size.
The boundaries between the urinary bladder and rectum have become clearer, and the rectum, which was previously displaced to the left, is now in a normal position.
This CT image was obtained 26 months later. Following herbal monotherapy alone, without the use of hormonal agents, the tumor has markedly regressed and is now barely visible along the left pelvic wall.
The image below was partially annotated using artificial intelligence, resulting in slight distortion of the original lesion appearance. The initial pelvic wall lymph node was depicted somewhat smaller than its actual original size.
The tumor that had previously invaded the urinary bladder wall has also completely regressed and is no longer visible on follow-up imaging.
The patient was subsequently followed for approximately two additional years and remained clinically stable without significant evidence of recurrence.
Conclusion) In the case presented above, the patient was treated without hormonal therapy. However, in later cases, patients were classified according to their individual characteristics, and treatment was combined with hormonal therapy protocols. I may present some of those cases in the future, but my conclusions differ somewhat from the conventional Western medical perspective.
Today, many newer agents have become available, but in earlier years the therapeutic options were much more limited.
The standard treatment for prostate cancer commonly included drugs such as bicalutamide, marketed under the trade name Casodex, along with several similar anti-androgen agents that have since been developed extensively.
In addition, injectable agents such as Lupron were used. These drugs are GnRH agonists administered by abdominal injection. In surgically eligible cases, bilateral orchiectomy was also performed, involving surgical removal of both testes in order to suppress androgen production.
| Generic Name | Brand Name |
|---|---|
| Leuprolide | Lupron |
| Goserelin | Zoladex |
| Triptorelin | Decapeptyl |
More recently, GnRH antagonists have also been increasingly utilized in the treatment of prostate cancer.
From the perspective of Sasang typology medicine, my personal interpretation of these therapeutic patterns is as follows:
- Taeeumin (태음인) → Casodex (bicalutamide)-based anti-androgen therapy
- Soeumin (소음인) → Proscar (finasteride), finasteride-related approaches, and GnRH antagonists
- Soyangin (소양인) → Zoladex, GnRH agonists, and Lupron-based therapy
This classification represents an interpretative framework based on Sasang constitutional medicine and does not correspond to an established standard within conventional oncology.
| Sasang Constitution | Drug | Class / Mechanism |
|---|---|---|
| Taeeumin | Casodex | Antiandrogen / Androgen receptor blockade |
| Soeumin | Proscar | 5α-reductase inhibitor / Suppression of DHT production |
| Soeumin | Degarelix | GnRH antagonist / Suppression of testosterone production |
| Soyangin | Zoladex | GnRH agonist / Initial stimulation followed by LH-Testosterone suppression |
Androgen signaling plays a central role in the growth and progression of prostate cancer.
In particular, the androgen receptor (AR) signaling pathway serves as one of the major driving forces that maintains the survival and proliferation of prostate cancer cells.
Under normal physiological conditions, the male hormone testosterone is converted within prostate tissue by the enzyme 5-alpha reductase into a more potent androgen known as DHT (dihydrotestosterone).
DHT then binds to the androgen receptor and translocates into the cell nucleus, where it activates the expression of multiple genes involved in cellular growth and proliferation. As a result, prostate cells are stimulated to grow and divide, and prostate cancer cells likewise exploit this signaling pathway to sustain continuous tumor growth.
Therefore, during the 2000s, when this patient was treated, the central therapeutic strategy in prostate cancer management was to suppress the androgen signaling axis.
The first major approach was to reduce testosterone production itself.
This was achieved through methods such as GnRH agonists or surgical orchiectomy, both of which suppress testosterone production from the testes.
From the perspective of Sasang constitutional medicine, however, GnRH agonists may be interpreted differently. These agents are also widely used in breast cancer therapy as estrogen-suppressing drugs. In Sasang theory, estrogen may be viewed as having a relatively Soyang-type characteristic. Therefore, suppressing estrogen could theoretically be interpreted as shifting toward a more Soeum-type physiological state, potentially favoring relative androgenic activity.
Paradoxically, GnRH agonists initially produce a temporary surge in testosterone levels — the so-called “flare phenomenon” — before eventually causing profound suppression and depletion of testosterone through receptor downregulation and pituitary desensitization.
This conceptual interpretation remains controversial and does not represent an established view within conventional endocrinology or oncology.
The second strategy is to reduce the production of DHT.
This approach works by inhibiting 5-alpha reductase, thereby blocking the conversion of testosterone into the more potent androgen DHT.
From my clinical observations within the framework of Sasang constitutional medicine, this therapeutic mechanism appears to respond more favorably in Soeumin-type patients. In contrast, Soeumin patients often do not show sustained responses to bicalutamide-based antiandrogen therapy alone. Although PSA levels or tumor activity may decrease temporarily, in many cases they eventually rise again over time.
This interpretation is based on personal clinical experience and constitutional medicine theory, and it does not represent an established consensus within conventional oncology.
The third strategy is to block the androgen receptor itself.
Antiandrogen agents such as bicalutamide competitively bind to the androgen receptor, thereby preventing the biological action of DHT.
However, based on actual clinical observations, this class of medication appears to be particularly suitable for Taeeumin-type patients within the framework of Sasang constitutional medicine.
In this sense, prostate cancer treatment was not simply a strategy aimed at directly attacking the tumor itself, but rather an endocrinological approach designed to shut down the “hormonal fuel supply” upon which the cancer cells depend.
Among the three major therapeutic strategies discussed above, aside from surgical orchiectomy, I would like to present my personal perspective regarding the use of Lupron.
According to the conventional mechanism, Lupron (generic name: leuprolide) is a GnRH agonist widely used in the treatment of prostate cancer.
One characteristic feature observed after the initial administration of this drug is the temporary occurrence of the so-called “flare phenomenon.”
The mechanism can be explained as follows.
Under normal physiological conditions, the hypothalamus releases GnRH in a pulsatile manner, and the pituitary gland responds by secreting LH and FSH.
LH then stimulates the Leydig cells of the testes, leading to increased testosterone production.
When Lupron is administered, it initially acts as a strong stimulator of the GnRH receptor.
As a result, during the first 1–2 weeks of treatment, the following temporary hormonal changes may occur:
- Increased LH secretion
- Increased testosterone production
- Increased DHT levels
- Increased androgen receptor activation
This transient hormonal surge is known as the “flare phenomenon.”
The following summarizes the conventional explanation of Lupron (leuprolide), a GnRH agonist, generated through discussion with ChatGPT regarding its mechanism and clinical background.
Clearly, this drug initially increases testosterone levels. Then why did it become established as a standard treatment for prostate cancer? The conventional explanation is that the temporary stimulation and flare phenomenon eventually lead to hormonal exhaustion and long-term testosterone suppression. However, from my perspective, this explanation appears highly paradoxical.
Nevertheless, Lupron became firmly established as a standard therapy in conventional oncology.
Many patients who come to me with advanced prostate cancer have either failed conventional treatment or were already in terminal stages at diagnosis. In such cases, I generally do not allow the use of Lupron-based therapy.
If the prostate cancer has been completely removed surgically, the situation may be different. However, in unresectable or advanced disease, I personally believe that avoiding Lupron alone may significantly improve the long-term clinical course.
Prostate cancer often progresses relatively slowly, yet eventually metastasizes extensively to bone. One of the reasons for this pattern, in my view, may be related to the testosterone-stimulating effect associated with Lupron during the flare phase.
Therefore, in terminal prostate cancer patients, I have observed surprisingly favorable responses when treatment is limited to:
- Taeeumin → bicalutamide-based therapy
- Soeumin → Proscar (finasteride)-based therapy
combined with herbal constitutional medicine.
I may present such cases in the future.
I have also observed that many physicians treating prostate cancer eventually develop a somewhat pessimistic attitude toward long-term outcomes. Although the disease may initially appear controlled, many believe that the cancer ultimately continues to grow slowly over time, eventually spreading to bone and leading to death.
From my perspective, this may partly reflect the androgen-stimulating effects associated with Lupron. The conventional theory argues that after complete hormonal exhaustion the androgen effect disappears, and pharmaceutical studies supporting Lupron established it as a standard therapy through clinical trials and published data.
However, within the framework of Sasang constitutional medicine, I believe the response differs fundamentally according to constitutional type. Soyangin patients may tolerate or respond to GnRH agonists, but in Soeumin and Taeeumin patients these agents may potentially worsen the condition significantly.
Even the conventional explanation itself acknowledges transient complications during the flare phase, including:
- Worsening bone pain
- Aggravation of urinary obstruction
- Temporary PSA elevation
- Risk of spinal cord compression in patients with vertebral metastasis
- Urinary retention
In Sasang medicine, constitutional classification serves as a fundamental organizing principle. Hormonal responses themselves may also differ according to constitutional type.
For this reason, I interpret Leuprolide (Lupron) as a “Soyangin-type medication,” and I believe it should not generally be used in Soeumin or Taeeumin patients.
Likewise, in breast cancer treatment, I have observed that GnRH agonist-based therapy appears to respond primarily in Soyangin patients, whereas outcomes in Soeumin and Taeeumin patients are often less favorable.
This interpretation represents a personal constitutional-medicine perspective and does not reflect an established consensus within conventional oncology or endocrinology.
