However, research and clinical trials is often not the same thing. In 2004, the Fortune Magazine (USA) published an article which pointed out that in the clinical trials of drugs in cancer treatment “the goal is not on saving lives” but on doing "proper" science.” The article asked, “If you've spent ten-plus years to discover that a new drug shrinks a tumour by an average of 10% more than the existing standard of care, how many people have you really helped? For the two widely publicized drugs, Erbitus and Avastin, the article concluded that: “Neither drug will save more than a handful of the 57,000 people who will die of colorectal cancer this year.”
Once I put great hope on Avastin, an anti-angiogenic drug. My first patient given the drug was a cancer patient with advanced stomach cancer with multiple liver metastases, accompanied with bloody ascites and serious jaundice. After he had been refused treatment by a hospital in Shanghai, his family members sent him to our hospital in a chartered train coach. I let her try Avastin for two weeks, her condition improved by 90%, and 70% of liver metastasis lesions were eliminated. Even though it was for a period of four months, I had confidence on the prospect of the drug and continued to use it on other patients whom other therapies had failed to work. Later, I treated a patient with advanced colorectal cancer which agonized and sent me into deep thoughts. After he had been given Avastin for three courses, the patient suddenly had an uncontrollable acute hemorrhage of the intestines. Urgent gastroscopy and colonoscopy were performed but they could not trace the source of bleeding. Celiac artery angiography suggested intestinal bleeding at the middle section of the small intestine. Rapid blood transfusion was given but the bleeding was far greater in volume than that could be replaced by blood transfusion. During my decades of being a gastroenterologist, I had not come across a single case with profuse bleeding of this scale. While I was busy instructing doctors to take a variety of therapeutic measures, my heart was trembling at the same time. I saw right in front of me the patient who initially was conscious fell into coma, the blood pressure fell from 140 to 50, 40 and finally 0. The patient died! His family members were Christians, they did not blame me but instead they held my hands and said: “Thank you. You had tried your best and God has called him home.” Still my heart was engulfed in pain. I recalled all my patients who had been treated with Avastin and I asked myself repeatedly: Avastin has been experimented in the USA for more than 10 years. Billion of dollars had been spent. 400 end stage colorectal cancer patients were tested with the drug, and the average survival period was extended by 4.7 months as compared to those who were not given the medicine. This figure might be meaningful to researchers. But to end stage colorectal patients whose average life would not exceed 16 months, how significant is that figure? Furthermore, 70% of patients would experience various side effects. Worse still, the expenses incurred amounted to tens of thousands RMB per week.
At the end of 2009, I went to the Philippines. Mr. B. Guingona, the former vice president of the Philippines received me at his residence. We talked about his brother’s treatment in our hospital. His brother was suffering from pancreatic cancer with liver metastasis. The former vice president said, “The reason that my brother’s condition has improved, or at least stabilized in your hospital is that your doctors give patients the most needed treatment only.”
We must build a new cancer culture. The starting point of this culture is "people-centred". Doctors have to pay attention around their patients as a whole and not around cancer. Life is precious, cherish life. Be concerned about patients’ lives the same way as we are concerned about ourselves.