Traditional Chinese Medicine as Adjunctive Care in Cancer and Rheumatoid Arthritis: A Narrative Review of Shared Frameworks and Evidence Gaps.

Abstract

Traditional Chinese medicine (TCM) has increasingly been investigated as an adjunctive approach to conventional treatment in chronic and complex diseases, including cancer and rheumatoid arthritis (RA). Although cancer and RA differ substantially in pathogenesis and therapeutic goals, both are associated with persistent symptom burden, treatment-related adverse effects, impaired physical function, psychological distress, and long-term supportive-care needs. This narrative review evaluates TCM within this shared adjunctive-care framework while maintaining disease-specific interpretation of the available evidence. In cancer, TCM-related interventions have been investigated for supportive symptom management, pain relief, treatment tolerance, quality-of-life improvement, and potential modulation of biological processes, including apoptosis, angiogenesis, immune regulation, invasion, metastasis, and multidrug resistance. In RA, Chinese herbal medicines, acupuncture, and related approaches have been evaluated for their potential effects on pain, inflammation, physical function, bone remodeling, and early disease-related processes. TCM-related mind-body practices, such as qigong and tai chi, may also provide psychological support, whereas mindfulness-based interventions are considered supportive-care strategies rather than TCM interventions. Current evidence ranges from mechanistic and preclinical studies to observational studies, single-arm clinical studies, randomized controlled trials, systematic reviews, and meta-analyses, with substantial variation in methodological quality. Overall, TCM should be considered a potential complement to, rather than a replacement for, established oncological or rheumatological treatment. Further well-designed clinical studies, standardized interventions, rigorous quality control, safety monitoring, and clinically meaningful outcome assessment are required to define its appropriate role in multidisciplinary care.