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Protocol Outlines Delphi Survey for Chinese Herbal Medicine Use in Colorectal CancerNew Rules for Using Herbs With Cancer Care

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Key Takeaway
Note this protocol outlines a planned Delphi survey on Chinese Herbal Medicine for colorectal cancer, not evidence.

This publication describes a study protocol for a Delphi Expert Consensus survey focused on colorectal cancer management. The primary objective is to achieve expert consensus on the usage of Chinese Herbal Medicine as a complementary therapy. The survey intends to address secondary outcomes including optimal intervention strategies, recommended stage and duration of intervention, safety considerations, and possible herb-drug interactions.

No main results are reported in this document, as it outlines the planned methodology rather than completed findings. Population details, sample size, setting, and follow-up duration are not reported. Consequently, specific efficacy data or adverse event rates cannot be derived from this source. The absence of reported safety data, including serious adverse events or discontinuations, highlights the preliminary nature of this work.

The stated practice relevance is to support safe, consistent, and evidence-informed clinical practice. However, limitations regarding funding or conflicts of interest are not reported. Clinicians should recognize that this represents a planned approach to consensus building rather than established evidence from a completed trial or systematic review. Until the survey is completed and published, recommendations remain theoretical.

Understanding the scope of this protocol is essential for interpreting future findings. The focus on herb-drug interactions suggests a need for vigilance when integrating complementary therapies. Without reported certainty or causality notes, the strength of future recommendations remains uncertain until data collection concludes.

Imagine standing in a doctor's office. You are ready to start treatment for colorectal cancer. Your doctor suggests adding Chinese herbal medicine to your plan. You feel hopeful. But then a question stops you cold. Which herbs are safe? How long should you take them? What if they fight with your other medicines?

This confusion is real. Many patients want to use natural remedies alongside standard care. They hope to feel better and reduce side effects. But without clear rules, things get messy.

Colorectal cancer is a major health problem worldwide. It affects millions of people every year. Current treatments like surgery and chemotherapy can work well. But they often cause tough side effects. Nausea, fatigue, and pain are common.

Many patients turn to Chinese herbal medicine to help. They want to feel stronger during treatment. They hope herbs will lower stress and improve daily life. This desire is completely understandable.

However, the current situation is messy. Doctors use different herbs in different ways. Some use them early in treatment. Others wait until later. There are no standard rules for who gets them or for how long.

This lack of consistency is frustrating. It makes it hard for doctors to know what is safe. It also makes it hard for patients to trust their treatment plan. We need clear answers. We need a plan that everyone can follow.

The surprising shift

For a long time, doctors and patients tried things on their own. Everyone did it differently. Some studies looked at single herbs. Others looked at complex mixtures. The results were often mixed.

But here is the twist. Instead of guessing, experts are coming together to make rules. This study uses a special method called the Delphi technique. It brings together many top experts from around the world.

These experts will vote on what is safe and what is not. They will decide the best times to use herbs. They will also check for dangerous interactions with standard drugs. The goal is simple: create a safe, standard guide for doctors and patients.

What scientists didn't expect

You might think experts already know everything. But the reality is different. The world of herbal medicine is huge. There are thousands of different plants. Many have not been studied in depth with cancer patients.

This study will ask experts to weigh in on specific questions. Will this herb help with nausea? Is it safe to take with chemotherapy? How long should a patient take it?

The experts will answer these questions in two rounds. They will vote anonymously online. If most experts agree, a rule is made. If they disagree, the question goes back for more discussion. This process ensures the final rules are strong and backed by expert opinion.

The big picture

This research is happening now. It is being planned to start soon. The team has already gotten approval from an ethics board. This means they are ready to begin the work.

The study will invite experts from many countries. They will share their knowledge and experience. Together, they will build a guide that fits real-world needs. This guide will help doctors talk to patients with confidence.

If you have colorectal cancer, this study is important news. It means clearer answers are coming. You will not have to guess about herbs anymore.

However, there is a catch. These new rules are not ready yet. The study is still in the planning stage. You cannot start taking new herbs based on this news today.

Talk to your doctor first. Do not change your treatment plan on your own. Your doctor knows your specific health needs. They can tell you if herbs are right for you right now.

The hidden risks

Using herbs with cancer drugs is not always safe. Some herbs can change how your body processes medicine. This can make drugs too strong or too weak. It can also cause new side effects.

That is why we need expert rules. We need to know exactly which herbs are safe. We need to know the right dose and the right time. This study will find those answers.

What happens next

The experts will meet in two rounds. They will review the questions and vote. After the first round, they will remove the easy questions. Then they will vote again on the hard ones.

The final result will be a clear set of guidelines. These guidelines will be published in medical journals. Doctors will use them to help their patients.

This process takes time. Research is never fast. But the result will be worth the wait. A clear guide will bring safety and peace of mind to patients everywhere.

This project will finish soon. The team will share their findings with the world. They will publish the results in a peer-reviewed journal. They will also present at major medical conferences.

Doctors around the world will read these new rules. They will update their practices to match the new standards. Patients will finally have a clear path forward.

The goal is simple: safe, effective, and consistent care. By working together, experts are building a better future for cancer patients. You can trust that science and care are moving in the right direction.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedApr 2026
View Original Abstract ↓
Introduction: Colorectal cancer (CRC) remains a leading cause of cancer-related morbidity and mortality worldwide, despite advances in conventional oncological therapies. In recent years, various studies have made advances in integrative oncology, such as investigating the use of Chinese Herbal Medicine (CHM) as a complementary therapy alongside conventional oncological therapies to alleviate treatment-related adverse effects, improve quality of life, and potentially enhance therapeutic outcomes. Despite this, clinical practice in this area remains highly heterogeneous, with limited standardized guidelines on key areas of concern such as (1) optimal intervention, (2) recommended stage and duration of intervention, (3) safety considerations, and (4) possible herb-drug interactions. Hence, this study aims to establish expert consensus on the usage of CHM as a complementary therapy in the management of CRC, to support safe, consistent, and evidence-informed clinical practice. Methods and Analysis: We will employ a modified Delphi technique to achieve consensus amongst a panel of international experts in various fields related to integrative oncology. Prior to the study, a list of questionnaire items was developed based on a systematic review of existing clinical practice guidelines on CRC. An international panel will be invited based on established international profile in integrative oncology research and clinical practice, and by peer referral. Two rounds of Delphi will be conducted using anonymous online questionnaires. Consensus will be considered reached if at least 50% of the panel strongly agree/disagree that an item should be included or excluded while strong consensus will be set at 76%. Items which achieve strong consensus after Round 1 will be removed, before being sent out for Round 2 with a summary of Round 1 responses for a final consensus. Ethics and Dissemination: Ethics approval has been obtained from the Institutional Review Board of Nanyang Technological University (IRB-2025-1222). Our findings will be disseminated through peer-reviewed publications and conference presentations.
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