Once an expert in the medical community said to me, “We should treat some valuable patients.”
‘Valuable patients’ certainly refers to those patients who are curable and those patients whom have a good result from the medical treatments. This expert was not malicious but from this I understand why Peng Ximei wandered in a Chinese hospital for two months, people turning a blind eye to her continuous enlargement of ovarian tumors and why Liangliang, the Malaysian pancreatic patient, failed to receive the correct treatment until he was on the verge of death and also why Lana from Saudi Arabia had her life, almost ruined even before she reached the age of one year. This was because treating patients with complex cases like these, were in some doctors’ eyes, considered a worthless effort. Meaning that they believed no matter what treatments were given to these patients, they couldn’t be saved.
So is it valuable to try and treat acute promyelocytic leukaemia? Forty years ago, the one-year survival rate for this cancer was less than 10%, most patients would die within six months. Academician Wang Zhenyi did not think that it was worthless trying to treat them. He could see these patients after receiving chemotherapy had serious side effects such as vomiting, diarrhoea and at the same time their illness still deteriorated, there was bleeding, multiple organs failure and death. As a doctor, he felt miserable and powerless when facing this cruel disease so he decided to research a new method of activating leukaemia cells transformed from regular leukaemia retracing themselves. Hence he experimented with ‘all-trans retinoic acid’ which at that time was the only one that existed on the market. Professor Wang gained enormous success and because of his achievements this ‘worthless’ acute promyelocytic leukaemia's cure rate reached above 95%, creating a miracle in the history of leukaemia treatment. Forty years later, he won the State’s Top Science and Technology Award. Last year, the American National Foundation for Cancer Research announced Professor Wang Zhenyi and Professor Chen Zhu were rewarded with the seventh Szent-Gyorgyi Prize for significant progress in cancer research.
Life comes first. A doctor’s duty is to cherish life and save lives, regardless of ‘value’ or ‘worth’.
Imagine if we just treat ‘valuable’ lives. Does it mean that many ‘worthless’ lives should be lost? If we just treated ‘valuable’ lives, how could medical science develop and advance?
Recently, I received an e-mail from the Danish lady, Gurlin, copied as follows-
From Gurli, Copenhagen
Sender: Gurli Gregersen
Date: 16/12/2011 5:20 p.m.
Receiver: xukc@vip.163.com
Dear Chinese family from Fuda,
I am very happy to inform you, that yesterday I got an answer from a scan on my local hospital. They were very happy. Everything looks fine and thanks to you, there are no tumours to see right now. So as you can understand I am so happy, that I can come back to you, Fuda and Guangzhou once a year.
I am still working on the medical report I promised to send you.
Best wishes
Gurli
In fact, successful treatment of every “worthless” patient is to create a new life. That is to promote the value of medicine and enrich love in the world.
This lady is a patient who was introduced in my book ‘Nothing But The Truth’. She is from Copenhagen, Denmark and suffered from pancreatic cancer which is known as ‘The King of Cancer.’ In October 2007, Gurli felt severe abdominal pain (cholecystalgia) and went to the local hospital for investigation. The hospital discovered that there were 2.8 cm pancreatic lesions with three 2-3 cm liver metastases. Biopsy proved this to be pancreatic cancer with liver metastases. She undertook Gemzar-based chemotherapy, but failed to get good results. Her daughter reviewed the world’s medical literature and found that chemotherapy was the only treatment for metastatic pancreatic cancer and the survival time was generally not more than six months. Then after an unexpected opportunity, she met Lira, a patient who had returned from our hospital. This 21-year-old lady suffered from thoracic chondrocytes osteosarcoma and had received surgery in Denmark. After the surgery her condition deteriorated, resulting in lower limb paralysis, so she went to the United States to receive high-dose chemotherapy and stem cell transplantation, which cured her paralysis but caused sepsis. After anti-infection treatment, she recovered from sepsis, but a dozen metastases appeared on her lungs and chest wall. She came to China to receive cryosurgery in our hospital and her condition was well under control. Gurli followed Lira’s advice, raising money in the fastest way. Eventually she flew to China in March 2008, accompanied by Danish reporters who were full of hesitation. They recorded the whole treatment process of Gurli including Cryosurgery, Radioactive Iodine Seeds Implantation and Vascular Intervention Therapy. After one month she was discharged from hospital. Two months later she came back for checkups, the CT scan she brought from Denmark showed that the pancreatic tumor had shrunk by 1/3 and the liver metastases had disappeared. Afterwards the tumor spread to the lymph node in the abdominal cavity and liver and she underwent cryo-ablation therapy. Subsequently, Gurli came to our hospital at least once a year for immunotherapy. The last time she visited our hospital was the 28th of October 2011. She stayed in the hospital for thirteen days for immunotherapy and thereafter toured China.
For metastatic pancreatic cancer patients, if chemotherapy fails according to current understanding it seems that they are not ‘worthy’ patients. Apparently Gurli was the ‘worthless’ patient. However, Gurli did not yield to her illness but came to our hospital for further treatment. From the date of the first admission to the hospital, she has survived for nearly five years, and she continues to live on (Figure 23).
These days, Gurli promotes her home in China. She says China has given her a new life. Dr. Mu Feng and I were invited to visit Denmark by the Danish Cancer Society. When we arrived at the exit of Copenhagen Airport, Miss Gurli was shining with happiness and called our names, waving the national flag of the People's Republic of China in her hands, I suddenly felt that this is what was ‘valuable’. The national flag of China being waved in Europe, which made the value of life as a doctor real and also reflected China's immeasurable value.
Therefore, we cannot easily define which patients are ‘valuable' and which are ‘worthless’. We can make great efforts to turn ‘worthless’ patients into ‘valuable’ patients. Taking the ‘King of Cancer’ (pancreatic cancer) for example, we have concluded that the one-year survival rates of two groups of patients from 49 cases and 59 cases of stage 3b or stage 4. The so-called ‘worthless’ patient’s survival rates were respectively 63% and 61% after cryosurgery-based combined therapy. This is much higher than those patients with similar cases who received conventional treatments.