In July Xu, 25, announced on the Chinese social media website Weibo she had lymphoma, a cancer of the lymphatic system that best responds to chemotherapy as a first-line treatment.
However, Xu said the high cost of chemotherapy in China and her fears about side effects and pain meant she had decided to treat her cancer with a mix of Chinese therapies instead.
“No matter how long I live, I want to enjoy every day happily,” she wrote, adding that she did not want to “let chemotherapy torment me to the point where there’s no beauty and talent left”. The actress appeared on television in the series Dad Home and acted in the comedy Lost In Macau.
Later in July, Xu posted photos to Weibo of the aftermath of some of the alternative treatments she had undergone, including acupuncture and cupping, which involves placing a flammable substance into a cup, typically a cotton bud, and setting it on fire. As the fire goes out, the cup is placed upside down on the skin, usually the back, creating a vacuum and leaving welts on the body.
Some users begged her to seek chemotherapy. One user wrote on her Weibo page: “You need to rely on modern medicine to save yourself.”
The American Cancer Society guide to complementary and alternative therapies warns of the risk of burns from cupping and states that “available scientific evidence does not support claims that cupping has any health benefits”.
Xu also turned to gua sha, a treatment that involves scraping the skin with a tool, and which is practised by the actor Gwyneth Paltrow and the swimmer Michael Phelps. It left Xu with red marks and bruising down her neck.
“Frankly, traditional Chinese medicine is also painful,” Xu wrote as a caption underneath one of the images of the treatment she posted to her blog.
According to a study published in the journal Complementary Therapies in Medicine, gua sha users in Hong Kong tended to use it mostly to treat respiratory and pain problems.
In August, Xu’s sister encouraged her to undergo chemotherapy as she became more unwell. Xu died on 7 September, shortly after starting chemotherapy.
Her death has sparked a debate in the Chinese media about the use and effectiveness of Chinese therapies. On the Chinese news website people.cn, the head of the traditional Chinese medicine department at the Chinese Academy of Medical Sciences in Beijing, Dr Feng Li, wrote that Chinese therapies should not be blamed for Xu’s death.
He wrote that “while western approaches like radiology, chemotherapy, and surgery are effective in shrinking the tumour”, Chinese therapies were “effective in reducing symptoms such as nausea, vomiting and pain that comes with western treatment”.
“Moreover, after the tumour is under control, traditional Chinese medicine helps to repair the immune system, accelerate the body’s recovery and minimise the chance of the tumour returning.”
A 2014 review of complementary and alternative medicine for cancer pain found alternative treatments, including Chinese treatments, had “low or moderate” evidence for alleviating cancer pain.
But a peer-reviewed paper published in the journal Cancer and Oncology Pain described the barriers some people faced obtaining conventional medical treatment. Led by Dr David Garfield from the ProMed Cancer Centre in Shanghai, the authors wrote that “Mainland Chinese attitudes are different from what we are accustomed to in the west”.
“There is a lack of trust between patients/families and physicians, related in part to there being few urban general practitioners, resulting in no longstanding, physician-patient relationships,” the authors wrote.
“There is a feeling that care is being provided for personal gain, much more so than in the west. When individuals are ill, or think they may be, they go directly to hospitals, including traditional Chinese medicine hospitals, rather than seeing a non–hospital-based practitioner.”
“Anti-cancer drugs, even for patients treated in public hospitals, are costly,” the authors added, writing that proven and effective treatments “although available, are out of reach for all but the wealthy”.
Cost, rather than mistrust, appeared to be a factor for Xu shunning chemotherapy. In one post on her Weibo blog, she wrote about how exhausted she was from trying to provide for her family financially.
“Over the past five years, I worked very hard to support the large family,” she wrote. “I made money to pay for my younger brother’s tuition fees, pay my parents debts and even buy a house. The pressure made me breathless.”
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