On Friday the 20th of January 2006, I'd just arrived back from overseas and at eight o'clock that evening received a call from Dr. Guo Dehong, the Medical Director of our hospital informing me that he had arranged a PET-CT scan for me the following day. Spring festival was approaching and there was a lot to attend to at the hospital. I said “there was no time” and more importantly I felt fine, I didn't feel sick and had no pain. In my opinion there was no reason for me to have any medical issues. I told Director Guo, “Let’s talk about it later”. Director Guo authoritatively responded“We’ve arranged this for you three times, this time you should have a check.” “Then I'll have a heart checkup” I could accept this as I was over sixty years old and the heart will always present problems for the elderly.
I arrived on time at 8 am the next day at the PET scan center. Director Yin had arranged for me to have my abdomen checked in the morning and my chest in the afternoon. Director Yin is a famous imaging expert in Guangzhou, naturally I would follow his protocols. The procedure went smoothly and consisted of a blood glucose test, an allergy test, a rest in the lounge, an intravenous injection of radionuclide (18F-FDG with a twohour half-life), and an hour’s wait and followed then with a twenty-minute scan. When it was all over, I ended up sitting in the VIP lounge on a comfy sofa reading newspaper and drinking milk to relieve the hunger from fasting.
Fifteen minutes later, Director Yin came and asked me if I had any problems with my liver. “There's no major problem with my liver, apart from having a fatty liver!” I blurted. Director Yin asked “Any lesions?” “Ah” I suddenly recalled“Hemangioma, it was discovered several years ago and confirmed by ultrasound, CT and MRI scans!” My head felt muddled, I tried to pull myself together and walked towards the control room of the PET center. There was an image of my liver displayed on the computer screen with a clear circular red area, the size of a coin on the left lobe. I suddenly understood, I'd misdiagnosed my cancer eight years ago.
My mind became confused, although I'd been a doctor for forty years, diagnosing and treating countless cancer patients, when faced with cancer myself I was filled with fear. I slumped on the sofa, heart beating fast, trying so hard to stop myself from crying. In front of my eyes, I could see my mother who, thirtyfive years ago had suffered and died tragically of liver cancer. Scenes flooded my mind like watching a film: my wife with her heart disease, having to summon my son to return home from the United States whilst he was in the process of building a business, my adorable two-year-old grandson, the cancer hospital I'd established and was developing, the cryotherapy monograph currently being prepared for publication as well as all my cancer patients.
Director Yin looked and me and said, “President Xu, CT films still need to be processed and undergo a group consultation. PET-CT scan results can have a false positive.” I knew he wanted to comfort me.
I went back to my office, turned on the computer and browsed the web. The General Manager of the hospital Mr. Zuo Jiansheng came in. He was twenty years younger than me and of a new clinical generation. He had worked in the department where I was director since he had graduated with a Master's degree. We have worked together for fifteen years and have a familiarity not unlike father and son. He looked at me smiling, but I could tell it was false. Awkwardly he said, “Director Yin has just called and told me you have a liver hemangioma.” I looked at him, tears had flooded his eyes and said, “Jiansheng, do the hepatic arteriography for me tomorrow.” He asked, “would you like me to accompany you to Shanghai and Beijing to look for expert consultations there?” “Don’t you know my profession?” I was shocked by my rage after I'd said this and regretted it.
Actually this burning anger was at myself. I felt hate and shame. As a doctor who had researched liver disease for decades I had misdiagnosed my illness for as long as eight
years. In 1998 an unexpected ultrasound examination revealed an occupying lesion on my liver. A further CT examination revealed that the occupying lesion had a fast flowing
appearance. Contrast agent was injected and quickly flowed in and out of the occupying lesion, with the diagnosis considered to be hemangioma. Two years earlier, an ultrasound doctor, whom I was not familiar with, asserted that the intrahepatic lesion was malignant, but because this doctor was not familiar in addition to the CT and MRI scans revealing a “fast flow rate” I had confirmed that the occupying lesion on the liver was indeed hemangioma.
The next day a Sunday morning, as I lay on the DSA treatment table, renowned vascular interventional expert, Dr. Luo Pengfei inserted a catheter into my left thigh's femoral artery. Less than ten seconds later a catheter went into the hepatic artery (presenting an inverted “J” shape) after which Dr. Luo told me to exhale, inhale and then hold my breath. Pushed by the autoinjector, contrast agents flew into the whole liver. Dr. Luo positioned the screen so that I was able to see it. I saw the white contrast agent rapidly spread into the lesion with no clusterings. Dr. Luo looked at me, without talking about angiographic results and just asked, “Mr. Xu, is it necessary to do a liver biopsy?” Dr. Luo was a very humble man and for many years had always referred to me as teacher Xu. Since the angiography did not indicate I had hemangioma, I felt calmer and said, “Thank you I'll have the biopsy done during surgery.”
“Please do the surgery for me immediately” I asked Professor Hu Yize who was by my side having accompanied me to the angiography. Professor Hu hesitated slightly but I stated, “I won't look for anybody else but you to do the surgery.” Professor Hu had been a friend for thirty years. He was the first graduate student of Academician Qiu Fazu, who had studied at the British Royal College of Physicians and the founder of Hepatobiliary Surgery in China. Professor Hu was one of the best experts in hepatobiliary surgery in Guangzhou. From the first day of establishing Fuda Cancer Hospital, he has been our hospital’s Chief Surgeon. Professor Hu took my hand and said, “Don't worry, I'm sure I can uproot the unwanted object.”