Living with cancer means people can enjoy a healthy and happy life even though there is tumor present.
Some people jokingly compare living with cancer to dancing with wolf since they believe that cancer is like a maneating animal that should be annihilated. That might be the reason why we rarely win in the fight against cancer in recent decades. Scientists have invested strenuous effort and spent enormous amount of scientific research funds on the development of numerous types of drugs for cancer, which, however, are only able to decrease the mortality rate of few types of cancer instead of many other types of cancer.
Many people don’t have a correct understanding of cancer treatment. As bad people are turned from good people, cancer cells are also transformed (mutated) from normal cells. Hence, it’s only a fantasy to end cancer for good. It’s right to suppress cancer cells turned from normal cells, but simple annihilation is not the final answer. The best result would be reaching a state of coexistence between good cells and cancer cells.
Survival is the top priority
My understanding of living with cancer comes not only from my professional exploration as a doctor but also from the experience of my relatives who had suffered from cancer. In particular, I’m also a cancer survivor. Unlike a doctor who is happy to see from the CT scan that tumor shrinks, what I’m concerned about as a cancer survivor is that whether I can survive. Different from some doctors who can achieve a sense of fulfillment when they write a nice paper about the result of a randomized controlled trial-the survival time of treatment group is several weeks more than that of control group, I’m more concerned about how long I could survive and whether I could work and enjoy my life. Hence, I believe survival is the top priority
My understanding of living with cancer also comes from the inspirations I have drawn during my exchanges with colleagues and counterparts. I would like to thank my mentor and the masters for their constant care, support and guidance.
The cruel reality
In 1971 when I was still a resident doctor, my mother came all the way from my hometown to visit me one day. I was so surprised to see her distended belly. It was until then did I know that she was diagnosed with advanced liver cancer. Two and a half months later, she was gone forever.
The cruel reality prompted me to study cancer, the early diagnosis of liver cancer in particular. However, most types of cancer are at progressive stage upon diagnosis and most cancer patients passed away within a short period of time like my mother.
One day in early 1997, in the simple office of the former health minister by Beihai, Prof. Chen Minzhang, then health minister, said to me, “There will be more and more cancer patients in the future. I suggest you to establish a cancer hospital with the focus on prolonging patients’ lifespan.”He further added, “Try your best to introduce some new treatments that can help people live with cancer.”
Chen Minzhang, then health minister, (L) and Xu Kecheng in 1997
It’s the first time that I had ever heard of the concept of living with cancer.
However, the next year, he died of cancer. “To prolong cancer patients’ life” has become the mission and the responsibility of doctors.
Argon-helium cryosurgery
In 1998, the American FDA approved Argon-Helium Cryotherapy System for ablation of localized tumor. Like a starchaser, I flew to California, America and then went to Irvine, a beautifully landscaped city that is 100 kilometers away from LA, to visit the company that was manufacturing argon-helium cryotherapy system. However, I was not allowed to record but look at it as it is a high technology. Then I went to a hospital that was more than 100 kilometers away from San Francisco. A professor of Stanford University displayed to me the achievement they made in the application of argon-helium cryosurgery for liver cancer. I was very excited, hoping that the technology was exactly the new method that health minister Chen has predicted.
We became the first few medical teams in China to have introduced argon-helium cryotherapy system from America at that time. My counterparts and I established Fuda Cancer Hospital with the new method as a core treatment.
We soon discovered that cryosurgery can replace surgical operation and even achieve radical cure for small tumor; it can deliver debulking effect for big tumors and even metastatic tumors. Debulking means if the tumor is unresectable, a part or the most part of the tumor can be resected through surgical operation so as to prolong patients’ life span. Cryosurgery seems to be able to deliver better debulking effect with the following reasons: firstly, cryosurgery can be carried out percutaneously, which minimizes the injuries made to patients; secondly, cryosurgery during surgical operation can better debulk the tumor; thirdly, a comparison of the long-term effect of surgical resection and cryosurgery on liver cancer found that few recurrence was detected after cryosurgery. It’s said after cryosurgery, very few basic growth factors will be generated as it will promote tumor recurrence; fourthly, research findings have shown that cryosurgery can induce an immunologic reaction (cryoimmunologic reaction) against cancer for eradication of residual or metastatic tumors.
Fuda Cancer Hospital carried out cryosurgery rapidly first for liver cancer and then for lung cancer and pancreatic cancer. It has also developed from cryosurgery during surgical operation to image-guided percutaneous cryosurgery and laparoscopic cryosurgery.
Percutaneous argon-helium cryosurgery
The joy of patients
I had been worried if the new technology could bring actual benefits to our patients. In 2006, we held a gathering themed on “I want to live” at a small restaurant in Xingang West Road, Guangzhou when we had done 1,000 cases of cryosurgery. Many of our patients who have undergone cryosurgery came to the gathering and shared with the audience how they weathered it through.
Mr. Lu, an engineer from Yiyang City, Hunan Province, shared with us how he went through the 100 days given by the doctors. He was diagnosed with lung cancer and doctors at a local hospital said he had only 100 days to live. His wife and he were counting down his given days in tears every day. Fortunately, his well-informed nephew suggested him to come to our hospital for treatment. Mr. Lu said in tears, “I have lived through 600 days.”
Mr. Tan is a young police officer from Yingde County that is over 100 kilometers away from Guangzhou. He once suffered from liver cancer sizing 13cm in diameter with ascites. He, who ever wanted to receive euthanasia, said, “I managed to survive. What a beautiful world it is!”
Our youngest patient Ming Zai has become a handsome boy today. More than 5 years ago, Ming Zai was once on the verge of death as he could not eat and speak due to the giant tumor in the neck. He was suffering from malignant teratoma, a congenital tumor. Currently, we cannot say that he is free of cancer but he is able to enjoy a normal life and go to school like a healthy child.
The joy and experience of patients have moved all the participants. Several experts from other hospitals spoke out their ideas. The director of the Department of Chemotherapy of a general hospital said, “As a doctor, we should put our patients in the first place. In the past, whatever the case is, we would always adopt chemotherapy for patients.” The director of the Department of Radiology of an affiliated hospital to a famous university said, “The same to us. We have always been suggesting patients to do chemotherapy. We shouldn’t simply think of killing cancer cells regardless of patients’ quality of life. It seemed that people can live with cancer.”
I believe I can live with cancer
In early 2006, I was diagnosed with liver cancer. I underwent tumor resection and the pathological result showed cholangiocarcinoma, the malignancy of which was much higher than that of hepatocelluar carcinoma. A literature focusing on cholangiocarcinoma among Chinese showed that the 5-year-survival rate is 5%; both chemotherapy and radiotherapy cannot improve the survival rate; what’s worse is that it tends to metastasize at early stage. To survive, I must hold a different way of thinking and strategy. I drawn up for myself a rehabilitation programme that include immunotherapy, nutrition support, and exercise. I firmly believed that I can live with cancer.
——Extracted from Living With Cancer
Xu Kecheng: chief physician, doctoral supervisor, chief president of Fuda Cancer Hospital, former president of International Society of Cryosurgery, laureate of Norman Bethune Medal, laureate of Role Model of the Times, chairman of Guangdong Provincial Light of Life Society for Cancer Rehabilitation, the 5th National Moral Model Award Nominee.
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