Urinary Difficulty after Chemotherapy: A Case Study

On the eve of the Lunar New Year I was asked to see an urgent case of urinary retention. The lessons were so instructive that I have written them down to share.

The patient, a woman who had undergone surgery for breast cancer, reported that after her fourth round of chemotherapy she developed a severe urinary-tract infection: urination was difficult and her lower abdomen ached. Western treatment began immediately—IV antibiotics and, surprisingly, even a proprietary Chinese formula meant to “clear heat and stop strangury.” The intervention was aggressive, yet the patient worsened: bowel movements became difficult, the lower abdomen remained sore, and sleep was almost impossible. The day before New Year’s she came to me for emergency help.

Her tongue was pale with a thick, white, greasy coating; the chi (proximal) pulse was almost imperceptible, while the left cun (distal) pulse felt like a small bean under light pressure. When I asked about her heart, she confirmed earlier cardiac problems. She felt cold, had abdominal pain, strained to urinate and defecate—clear signs of Kidney-Yang deficiency, a typical Shao-Yin pattern. Because the Kidney governs the two excretions, I prescribed Fu Zi Tang (Aconite Decoction) plus Gui Zhi (Cinnamon Twig) without hesitation. Knowing that couriers would soon stop for the holiday, I told her to buy Jin Gui Shen Qi Wan (the version containing Che Qian Zi/Plantago seed) as a temporary remedy.

After taking the pills her symptoms eased, but after each bowel movement the lower abdomen still felt sore. She asked what else could be done. The problem was that Shen Qi Wan warms Yang but does not raise Qi; after repeated infusions and chemotherapy her Qi had sunk. Therefore I had her apply moxibustion to Shui Quan (KI-5), Yin Ling Quan (SP-9) and Bai Hui (GV-20), and stick slices of Huang Qi (Astragalus) to the tips of her fingers.

The next day she started the decoction I had prescribed, continued the moxibustion and the Huang Qi plasters, and overall improvement was evident. In truth, this urinary difficulty was entirely the result of chemotherapy and the mismanagement that followed. After chemotherapy the patient’s Yang was already depleted: cytotoxic drugs kill not only cancer cells but many healthy ones as well. When toxins enter the body, the organism first mobilises a large amount of Yang Qi to fight them; in the struggle Yang is consumed. Yang Qi is like the body’s guard. Once it is weakened after chemotherapy, the Kidney’s transformative (qi-hua) power declines, giving rise to urinary difficulty—a dysfunction of the Bladder’s qi transformation (as described in Chinese medicine). At this point we need only warm Kidney-Yang. Yet Western medicine kept giving cold IV fluids, adding frost to snow. That is why, after warming herbs were given, she began to excrete the retained fluid; the water that had been infused had to leave the body somewhere.

This case illustrates the fundamental principle of treatment: protect the upright Qi (zheng qi). As Li Ke reminded us, the first priority is always to safeguard Stomach Qi and preserve Yang. Western medicine, focused on cancer cells and microbes, often overlooks—or cannot address—the need to protect the body’s own vital force. Many cancer patients ultimately die from exhaustion of this very Qi. In Chinese medicine we combine attack and support, constantly monitoring the state of upright Qi. When it becomes too weak we change tactics, preserving Qi and protecting Stomach function; only when the body is stronger do we again expel pathogenic factors. Furthermore, Chinese medicinals are natural rather than chemically synthesized toxins, so their injurious potential is far lower. Recently I have also studied the cancer-treatment acupuncture system developed by the elder physician Yu Yun; it is remarkably effective. Clearly, the role of Chinese medicine in cancer care is vast and promising.