西醫除了手術、化療、放療三板斧外，對不同的癌症是有不同的方法處理的。隻是還有一些腫瘤，其機製還沒搞清楚，或還沒有找到對應的方法而已。另外，許多外行人說的一種腫瘤，在西醫裏，是有不同的機製的，所以，對應的治療方法可以是完全不同的。隨著研究的深入，對應的治療方法會找出來的。
以我以前研究的乳腺癌為例，它初分為ER陽性和陰性。前者除了你說的三板斧之外，更多的是Tamoxifen和aromotase inhibitor來對付的。這種治療一般能有2-3年的效果。對陰性，除了三板斧，其他辦法不多。主要是機製太複雜。
有很多藥物，針對特定的腫瘤。查一下大的製藥公司的產品就知道了。隻是這些藥物隻能針對幾種特定的腫瘤中的一些亞型。腫瘤起源的機製太複雜，所以，沒有一種特效藥（化療除外）對付所有的腫瘤。所以，腫瘤的診斷（分型）也是目前的研究重點。
化療是利用腫瘤細胞生長快的特點來設計的。但這種療法的特點是副作用太大--人體裏正常細胞也要生長，也會被除掉。這就是新一代腫瘤藥物要克服的問題。
談到中（草）藥和西藥的結合，要先了解過去幾十年西藥研究的曆史。在藥物篩選（High throughput screening)上，一直是用簡單的化合物。人工合成的化合物，結構是不可能太複雜的。而自然界裏的一些化合物，尤其在植物裏，其結構要複雜得多。但沒有目標的分離純化成千上萬的化合物供藥物篩選可不容易。但有不少（尤其是當年前蘇聯分離純化的）已經進入藥物篩選係統。估計越來越多的天然化合物會進入藥物篩選庫。西方在腫瘤的知了上，近年在抗體上華了不少功夫，我沒有太跟蹤，對其前景不熟習，不敢評論。
中醫要進步，科學化是必不可免的。靠傳統的經驗是不會有進步的。必須用科學的辦法找出中藥中起作用的化學成分，作用機製，在加以完善。其實中西結合的最好例子在中國--中國治療malari瘧疾的藥物開發，就是從中藥裏指導一種植物有效，然後分離這個化學成分，然後在化學結構上加以修飾，合成了更好的抗瘧疾的藥物。
這是俺當年作的研究，被新聞報道過的：
New inhibitors of breast cancer cells identified
By Megan Rauscher Wednesday, Jun. 18, 2008; 3:33 AM
NEW YORK (Reuters Health) - A team of U.S. scientists has identified a new family of compounds that block the ability of estrogen to stimulate the growth of breast cancer cells.
"The lead inhibitor is quite effective in breast cancer cells that are resistant to tamoxifen," Dr. David J. Shapiro noted at the Endocrine Society's annual meeting underway in San Francisco.
"We are hopeful that as we proceed with further development that these compounds may ultimately lead to therapeutics that are clinically useful against some breast cancers that are resistant to current therapies," added Shapiro, a biochemist at the University of Illinois at Urbana-Champaign.
Currently available treatment for breast cancer driven by estrogen either interfere with estrogen production (e.g., aromatase inhibitors such as letrozole) or block estrogen's ability to bind to estrogen receptors on breast cancer cells (e.g., tamoxifen).
"We targeted a different step in the pathway of estrogen action," Shapiro said, "one that is not targeted by current therapeutics" -- namely, the expression of genes within cell that are controlled by estrogen receptor activity and that contribute to cancer growth.
The researchers found that a compound called TPBM blocked the estrogen-dependent growth of human breast cancer cells that carried estrogen receptors -- even cells resistant to tamoxifen treatment. If cells did not carry estrogen receptors (i.e., ER negative), they were not affected.
"Even at very high concentrations, TPBM has no effect on ER-negative cells, so it is not toxic to these cells at all," Shapiro said. "This gives us a lot of confidence as we go to animal studies that TPBM will not damage human cells."
He noted that while tamoxifen therapy is effective initially, "in essentially all patients, the tumors eventually become resistant to tamoxifen and resume their growth." This fact "underscores the importance of identifying new classes of therapeutic agents that will act outside of the hormone-binding pocket on the estrogen receptor."
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